TY - JOUR
T1 - Vulval lichen sclerosus in primary care: Thinking beyond thrush and genitourinary symptoms of the menopause
AU - Rees, Sophie
AU - Owen, Caroline
AU - Baumhauer, Clare
AU - Hillman, Sarah
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Vulval lichen sclerosus (VLS) is a chronic inflammatory skin condition. Prevalence remains unclear as it is likely underreported and underdiagnosed. It affected one in 70 women presenting to a general gynaecology clinic.1 It can have a significant impact on quality of life, affecting sexual function and restricting other activities of daily living such as toileting, sitting, exercising, and socialising. Women may experience a loss of sense of self.2 If untreated, VLS is a progressive disease, with potential to lead to distressing anatomical changes and malignancy. Early diagnosis and treatment are key to reducing the impact on women’s lives, and preventing long-term sequelae. General practice has a key role in enabling timely diagnosis and treatment, but women often report long delays to diagnosis despite repeatedly seeking help. Missed opportunities for diagnosis and the resulting distress were a major theme in the current authors’ recent study.2 VLS may be commonly misdiagnosed as candidiasis or genitourinary symptoms of menopause (GSM). With rising awareness of GSM and the shift to teleconsultations, delayed diagnosis by primary care practitioners is an increasing risk. While not mentioned in detail in the recently published Women’s Health Strategy,3 vulval disease is an important component of a number of its priority areas and must not be forgotten. This article describes practical information for GPs.
AB - Vulval lichen sclerosus (VLS) is a chronic inflammatory skin condition. Prevalence remains unclear as it is likely underreported and underdiagnosed. It affected one in 70 women presenting to a general gynaecology clinic.1 It can have a significant impact on quality of life, affecting sexual function and restricting other activities of daily living such as toileting, sitting, exercising, and socialising. Women may experience a loss of sense of self.2 If untreated, VLS is a progressive disease, with potential to lead to distressing anatomical changes and malignancy. Early diagnosis and treatment are key to reducing the impact on women’s lives, and preventing long-term sequelae. General practice has a key role in enabling timely diagnosis and treatment, but women often report long delays to diagnosis despite repeatedly seeking help. Missed opportunities for diagnosis and the resulting distress were a major theme in the current authors’ recent study.2 VLS may be commonly misdiagnosed as candidiasis or genitourinary symptoms of menopause (GSM). With rising awareness of GSM and the shift to teleconsultations, delayed diagnosis by primary care practitioners is an increasing risk. While not mentioned in detail in the recently published Women’s Health Strategy,3 vulval disease is an important component of a number of its priority areas and must not be forgotten. This article describes practical information for GPs.
UR - https://bjgp.org/content/73/730/234
U2 - 10.3399/BJGP23X732861
DO - 10.3399/BJGP23X732861
M3 - Article (Academic Journal)
SN - 0960-1643
VL - 73
SP - 234
EP - 236
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 730
ER -