Table 2.

Clinical features of vulvar lichen sclerosus.

Signs and symptoms

Asymptomatic

Chronic pruritus

Dyspareunia or apareunia

Anorgasmia

Dysuria

Genital bleeding

Constipation

Painful defecation

Pale lesion with atrophic changes in vulva

Loss of labia minora

Burying of the clitoris

Obstruction of urinary flow

Reduction of the vaginal introitus

Fourchette adhesions

Subepithelial hemorrhage due to pruritis

Classic “figure of eight” shape of the lesion

Comorbidities

Morphea or localized scleroderma

Systemic sclerosis

Hashimoto's thyroiditis

Rheumatoid arthritis

Psoriasis

Diabetes mellitus type 1

Alopecia areata

Overactive bladder

Stress urinary incontinence

Irritable bowel syndrome

Fibromyalgia

Temporomandibular joint disorder

Associated Malignancy

Neoplastic transformation to squamous cell carcinoma

Association with melanoma reported

Pschosexual Impact

Concerns of loss of relationships

Desires to regain intimacy and sexual enjoyment

Negative influence on female genital self-image

Negative correlation with sexual arousal, orgasm, and satisfaction rates

Less frequent sexual activity