A population-based case–control study of aetiological factors associated with vulval lichen sclerosus

Abstract

We aimed to investigate the association between possible aetiological factors and the risk of developing vulval lichen sclerosus (VLS). A population-based case–control questionnaire study was performed comparing women with a diagnosis of VLS (n= 92), with those attending a general gynaecology clinic with no known anogenital dermatosis (n= 66). After adjustment for confounders, factors associated with VLS included a family history of diabetes mellitus (OR= 7.0, p= 0.012) and previous pelvic surgery (OR= 4.75, p= 0.007). The use of barrier and progesterone only methods of contraception (OR= 0.19, p= 0.045), hormone replacement therapy (OR= 0.209, p= 0.025) or hayfever (OR= 0.18, p= 0.008) appeared to be associated with a reduced risk of VLS. In conclusion, we were unable to confirm many proposed aetiological theories associated with the development of VLS, in particular those associated with autoimmunity.

Keywords::

• Aetiology
• anogenital
• autoimmune
• lichen sclerosus
• vulva
• women

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Work was supported by the Scottish Hospital Endowments Research Trust (SHERT (S1/03)). This work was carried out at the University of Aberdeen while CAH was a Gynaecology Research Scholar.