Morphological features of various variants of the course of scleroatrophic lichen of the vulva

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Relevance. Most of the scientific papers presented in the literature indicate morphological features of the stages of development of sclerotic lichen of the vulva, or in comparison with other vulvar skin lesions. At the same time, data on the features of morphological examination of vulvar biopsies, depending on the clinical variants of the course of sclerotic lichen of the vulva, is currently insufficient. The aim of the study - to determine the presence or absence of distinctive morphological features of the sclerotic lichen of the vulva, depending on the clinical variants of its course. Materials and Methods. The study included 292 patients with sclerotic lichen of the vulva (20-70 years old). Based on the scale of assessment of objective and subjective clinical signs of sclerotic lichen of the vulva developed by us, 3 clinical groups: 101 patients with an atrophic variant of the course, 154 with a sclerosing variant and 37 patients with a scleroatrophic variant of the course of sclerotic lichen of the vulva. In addition to clinical laboratory, instrumental and immunological studies, all patients underwent incisional biopsy of the vulva followed by morphological examination of biopsies. Results and Discussion. The features of the results of morphological examination of various clinical variants of the course of sclerotic lichen of the vulva are described and presented in the form of images. The characteristic morphological signs for each clinical group, as well as common signs characteristic of all variants of the course of this pathology, were revealed. Morphological examination of vulvar tissues is informative only to confirm the diagnosis of «Sclerotic lichen of the vulva», to determine the stage of the disease, as well as to exclude the malignant process, while for a clear differentiation of variants of the clinical course of sclerotic lichen of the vulva, conventional morphological examination is not enough, which requires further studies using immunohistochemical and molecular genetic methods. Conclusion. The revealed differences in morphological parameters of various variants of the course of sclerotic lichen of the vulva are insufficiently specific, which excludes the possibility of accurate morphological verification of the variants of the course of sclerotic lichen of the vulva and confirms the expediency of using clinical classification of variants of the course of sclerotic lichen of the vulva based on objective and subjective clinical signs.

About the authors

Ekaterina V. Kolesnikova

Kuban State Medical University

Author for correspondence.
ORCID iD: 0000-0002-6537-2572
Krasnodar, Russian Federation

Alexander V. Zharov

Kuban State Medical University; Regional Clinical Hospital No. 2

ORCID iD: 0000-0002-5460-5959
Krasnodar, Russian Federation

Sergey S. Todorov

Rostov State Medical University

ORCID iD: 0000-0001-8476-5606
Rostov-on- Don, Russian Federation

Gregoriy A. Penzhoyan

Kuban State Medical University

ORCID iD: 0000-0002-8600-0532
Krasnodar, Russian Federation

Natalya V. Mingaleva

Kuban State Medical University

ORCID iD: 0000-0001-5440-3145
Krasnodar, Russian Federation


  1. Lichen sclerosus. Genetic and Rare Diseases. StatPearls Publishing. Treasure Island (FL). 2019. 1435 p.
  2. Lichen Sclerosus. NORD (National Organization for Rare Disorders). 2019. sclerosus/ Access date: 12.11.2022.
  3. Kirtschig G, Becker K, Günthert A, Jasaitiene D, Cooper S, Chi CC, Kreuter A, Rall KK, Aberer W, Riechardt S, Casabona F, Powell J, Brackenbury F, Erdmann R, Lazzeri M, Barbagli G, Wojnarowska F. Evidence-b ased (S3) Guideline on (anogenital) Lichen sclerosus. J Eur Acad Dermatol Venereol. 2015;(10): e1-43. doi: 10.1111/jdv.13136.
  4. Tran DA, Tan X, Macri CJ, Goldstein AT, Fu SW. Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets. Int J Biol Sci. 2019;15(7):1429-1439. doi: 10.7150/ijbs.34613.
  5. Hallopeau H. Lichen plan scléreux. Ann. Dermatol.Syph. 1889;20:447-449.
  6. Simpson RC, Cooper SM, Kirtschig G, Larsen S, Lawton S, McPhee M, Murphy R, Nunns D, Rees S, Tarpey M, Thomas KS; Lichen Sclerosus Priority Setting Partnership Steering Group. Future research priorities for lichen sclerosus - results of a James Lind Alliance Priority Setting Partnership. Br J Dermatol. 2019;180(5):1236- 1237. doi: 10.1111/bjd.17447.
  7. Krapf JM, Mitchell L, Holton MA, Goldstein AT. Vulvar Lichen Sclerosus: Current Perspectives. Int J Womens Health. 2020;12:11-20. doi: 10.2147/IJWH.S191200.
  8. Lynch PJ, Moyal-B arracco M, Scurry J, Stockdale C. 2011 ISSVD Terminology and classification of vulvar dermatological disorders: an approach to clinical diagnosis. J Low Genit Tract Dis. 2012;16(4):339-44. doi: 10.1097/LGT.0b013e3182494e8c.
  9. Papini M, Russo A, Simonetti O, Borghi A, Corazza M, Piaserico S, Feliciani C, Calzavara- Pinton P; Mucous Membrane Disorders Research Group of SIDeMaST. Diagnosis and management of cutaneous and anogenital lichen sclerosus: recommendations from the Italian Society of Dermatology (SIDeMaST). Ital J Dermatol Venerol. 2021;156(5):519-533. doi: 10.23736/S2784-8671.21.06764-X.
  10. Fistarol SK, Itin PH. Diagnosis and treatment of lichen sclerosus: an update. Am J Clin Dermatol. 2013;14(1):27-47. doi: 10.1007/s40257-012-0006-4.
  11. Regauer S, Liegl B, Reich O. Early vulvar lichen sclerosus: a histopathological challenge. Histopathology. 2005;47(4):340-7. doi: 10.1111/j.1365-2559.2005.02209.x.
  12. Attili VR, Attili SK. Clinical and histopathological spectrum of genital lichen sclerosus in 133 cases: Focus on the diagnosis of presclerotic disease. Indian J Dermatol Venereol Leprol. 2022;88(6):774 doi: 10.25259/IJDVL_640_20
  13. Pope E, Laxer RM. Diagnosis and management of morphea and lichen sclerosus and atrophicus in children. Pediatr Clin North Am. 2014;61(2):309-19. doi: 10.1016/j.pcl.2013.11.006
  14. Yadav D, Agarwal S, Thakur S, Ramam M. Lymphocyte- Peppered Sclerotic Collagen: An Additional Histological Clue in Lichen Sclerosus, Morphea, and Systemic Sclerosis. Am J Dermatopathol. 2021;43(12):935-938. doi: 10.1097/DAD.0000000000002071.
  15. Kolesnikova EV, Zharov AV, Penzhoyan GA. Role of cytokines in pathogenesis, diagnosis and efficiency evaluation of immunotherapy in various variants of sclerotic lichen in women. Medical Immunology (Russia). 2021;23(1):63-72. doi: 10.15789/1563-0625-ROC-2085. (In Russian).
  16. Sokolova AV, Apolikhina IA, Zaitsev NV, Chernukha LV. Clinical and morphological stages vulvar lichen sclerosus. Gynecology. 2020;22(4):22-27. doi: 10.26442/20795696.2020.4.20 0278. (In Russian).
  17. Micheletti L, Preti M, Radici G, Boveri S, Di Pumpo O, Privitera SS, Ghiringhello B, Benedetto C. Vulvar Lichen Sclerosus and Neoplastic Transformation: A Retrospective Study of 976 Cases. J Low Genit Tract Dis. 2016;20(2):180-183 doi: 10.1097/LGT.0000000000000186

Copyright (c) 2023 Kolesnikova E.V., Zharov A.V., Todorov S.S., Penzhoyan G.A., Mingaleva N.V.

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