The long-term clinical consequences of Juvenile Vulvar Lichen Sclerosus, a systematic review.

Abstract

BACKGROUND\nVulvar lichen sclerosus (VLS) occurring in juveniles (children and adolescents) may have repercussions throughout life.\n\n\nOBJECTIVE\nWe sought to assess the evidence available on the long-term consequences of juvenile vulvar lichen sclerosus (JVLS).\n\n\nMETHODS\nMultiple databases were searched for studies containing long-term follow-up information on children or adolescents up to age 18 with VLS. Articles were classified by level of evidence and the specific aspects of VLS studied.\n\n\nRESULTS\nIn all, 37 studies met the inclusion criteria giving information on long-term consequences of VLS, of which 13 were cohort studies and 24 case reports or series. These publications show that signs and symptoms persist after puberty and beyond, scarring and permanent architectural changes occur, treatment is effective with regard to symptoms, and long-term quality of life is affected. Findings suggest a possible relationship with risk of malignancy. The included publications had low-level evidence.\n\n\nLIMITATIONS\nMeta-analysis was not possible due to different focus of the studies. Very few subjects were followed into adulthood.\n\n\nCONCLUSIONS\nThere is low-level evidence suggesting long-term repercussions of JVLS. Studies following juveniles with VLS into adulthood are needed in order to better understand the course of this disease and its repercussions on adult vulvar health.