RESUMO
BACKGROUND/OBJECTIVES: Vulval lichen sclerosus (VLS) is a chronic inflammatory skin condition predominantly affecting the anogenital region in women and children. To date, there is lack of agreement amongst experts on a severity scale to aid assessment, research and treatment stratification on VLS. Furthermore, literature on best practice for long-term management of VLS is lacking. The aim of this consensus is to provide broad guidelines on the short and long-term management of VLS. METHODS: An initial focus group of Australasian experts in vulval dermatology developed a draft consensus statement for the management of VLS. Based on the results of the draft statement, a consensus panel of 22 Australasian experts, comprised of the initial and additional members, participated in an anonymous four-stage eDelphi process. Round 1 involved generation and voting on statements from the draft consensus statement developed by the focus group. In Rounds 2, 3 & 4, panel members were presented formal feedback from previous rounds and asked to indicate their level of agreement. Consensus was reached if there was ≥70% agreement on the importance of an item in the 4 (agree) to 5 (strongly agree) range. RESULTS: The expert panel, with a total of 504 collective years of experience in the field of VLS, reached consensus on a core set of 51 management statements related to diagnosis, severity, initial and long-term management, follow-up, and complications of VLS. CONCLUSIONS: This study has identified a set of management statements for VLS that may be useful in clinical practice in the Australasian population.
Assuntos
Consenso , Líquen Escleroso e Atrófico/terapia , Guias de Prática Clínica como Assunto/normas , Padrões de Prática Médica/normas , Líquen Escleroso Vulvar/terapia , Dermatologistas/normas , Feminino , Humanos , Líquen Escleroso e Atrófico/prevenção & controle , Líquen Escleroso Vulvar/prevenção & controleAssuntos
Carcinoma de Células Escamosas/prevenção & controle , Circuncisão Masculina , Doenças do Pênis/prevenção & controle , Neoplasias Penianas/prevenção & controle , Infecções Sexualmente Transmissíveis/prevenção & controle , Adulto , Balanite (Inflamação)/epidemiologia , Balanite (Inflamação)/prevenção & controle , Carcinoma in Situ/epidemiologia , Carcinoma in Situ/prevenção & controle , Carcinoma de Células Escamosas/epidemiologia , Criança , Pré-Escolar , Circuncisão Masculina/efeitos adversos , Circuncisão Masculina/psicologia , Circuncisão Masculina/estatística & dados numéricos , Cultura , Humanos , Recém-Nascido , Líquen Escleroso e Atrófico/epidemiologia , Líquen Escleroso e Atrófico/prevenção & controle , Masculino , Doenças do Pênis/epidemiologia , Neoplasias Penianas/epidemiologia , Fimose/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Religião , Infecções Sexualmente Transmissíveis/epidemiologiaRESUMO
Lichen sclerosus is a chronic inflammatory skin disorder that belongs to a group of autoimmune connective tissue diseases, localized within the skin and mucous membrane of the anogenital area. In the latter location, the focal atrophy of the mucosa is the most visible sign. Lesions may be accompanied by symptoms such as itching, pain, burning. The disease occurs more often in females. The etiology is not fully understood. Genetic, infectious, hormonal factors and autoimmune mechanisms are taken into consideration. Early diagnosis and appropriate treatment is important to avoid further complications. This review aims to analyze available literature on the treatment of this disease entity
Assuntos
Líquen Escleroso e Atrófico/diagnóstico , Líquen Escleroso e Atrófico/tratamento farmacológico , Líquen Escleroso Vulvar/diagnóstico , Líquen Escleroso Vulvar/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Feminino , Humanos , Imunossupressores/uso terapêutico , Líquen Escleroso e Atrófico/prevenção & controle , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Líquen Escleroso Vulvar/prevenção & controleAssuntos
Líquen Escleroso e Atrófico/prevenção & controle , Doenças Vaginais/prevenção & controle , Fármacos Dermatológicos/uso terapêutico , Feminino , Humanos , Imunossupressores/uso terapêutico , Líquen Escleroso e Atrófico/diagnóstico , Líquen Escleroso e Atrófico/tratamento farmacológico , Autorrelato , Doenças Vaginais/diagnóstico , Doenças Vaginais/tratamento farmacológicoRESUMO
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