Prognosis

Lichen sclerosus (LS) is a chronic condition with a relapsing and remitting course. Anogenital LS in women is not curable but can be maintained with appropriate medical therapies. In some cases of penile LS, the condition may be curable with early circumcision. Due to the chronic relapsing nature of anogenital LS, once disease control is achieved, it is important to consider long-term maintenance therapy, with outpatient follow-up frequency and duration tailored to the individual patient.[35][82]

For patients with more chronic or severe disease processes, while initial symptom control can be achieved with topical corticosteroids, long-term complications include scarring, dyspareunia, urinary tract complications, and pain syndromes. These complications should be adequately addressed in addition to maintaining therapies for underlying inflammation; the patient may require multimodal therapy, including topical therapies, systemic therapies, pelvic floor physiotherapy, and in some cases, surgical intervention.​[82][102]​​

Studies have shown that LS in girls may have a more chronic course than previously thought.[88][103]​ One observational retrospective study of 31 prepubertal girls diagnosed with LS who were followed up for clinical evaluation following menarche found that 58% still had symptomatic disease and a further 26% had persistent clinical signs of LS despite being asymptomatic.[88]

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