Annarosa Virgili1, Alessandro Borghi2, Simone Cazzaniga3,4, Anna Di Landro3, Luigi Naldi3,5, Sara Minghetti1, Maria T Fierro6, Anna Verrone6, Marzia Caproni7, Giuseppe Micali8, Valeria Gaspari9, Manuela Papini10, Vito Di Lernia11, Lerica Germi12, Giampiero Girolomoni13, Anna Belloni Fortina14, Serafinella P Cannavò15, Roberta Bilenchi16, Monica Corazza1. 1. Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy. 2. Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy - alessandro.borghi@unife.it. 3. GISED Research Center, FROM Foundation, Bergamo, Italy. 4. Department of Dermatology, Inselspital University Hospital, Bern, Switzerland. 5. Unit of Dermatology, Papa Giovanni XXIII Hospital, Bergamo, Italy. 6. Department of Dermosyphilopathy #2, Città della Salute e della Scienza, Turin, Italy. 7. Division of Rare Skin Diseases and Immunopathology, Unit of Dermatology I, University of Florence, Florence, Italy. 8. Unit of Dermatology, G. Rodolico University Hospital, Vittorio Emanuele Polyclinic Hospital, Catania, Italy. 9. Unit of Dermatology, Department of Specialty, Diagnostic, and Experimental Medicine, University of Bologna, Bologna, Italy. 10. Division of Clinical Dermatology in Terni, Department of Surgery and Biomedicine, University of Perugia, Perugia, Italy. 11. Unit of Immunodermatology and Pediatric Dermatology, Arcispedale Santa Maria Nuova, Reggio Emilia Hospital and IRCCS, Reggio Emilia, Italy. 12. Unit of Dermatology, San Bortolo Hospital, Vicenza, Italy. 13. Unit of Dermatology, Department of Medicine, Verona University Hospital, Verona, Italy. 14. Unit of Clinical Dermatology, Department of Medicine, Padua University Hospital, Padua, Italy. 15. Unit of Dermatology, Department of Specialty Medicine, Gaetano Martino Polyclinic Hospital, Messina, Italy. 16. Unit of Dermatology, Department of Clinical Medicine and Applied Immunology, Siena University Hospital, Siena, Italy.
Abstract
BACKGROUND: Studies specifically conducted to assess gender differences in genital lichen sclerosus (GLS) are not available. This multicenter study aimed to identify possible gender-related differences on GLS clinical features, history and course, through collecting data from a large mixed-sex sample of patients. METHODS: This was a cross-sectional study on 729 subjects (53.8% females, 46.2% males) affected with GLS, consecutively observed within a network of 15 Italian dermatology units. The following information was specifically collected: clinical features and severity of symptoms related to GLS, extragenital involvement, previous therapies, diagnostic suspicion at referral, type of referring physicians, development of genital squamous-cell carcinoma (SCC). RESULTS: Females complained of symptoms more frequent and severe than men; pallor and scarring-sclerosis-atrophy were the most frequent features without gender differences; itching-related signs were more frequent in females than in males as well as extragenital involvement; prior to receiving a definitive diagnosis, females received treatment more frequently than males; 40% of patients were referred with a misdiagnosis; the highest rate of correct suspected diagnosis at referral came from dermatologists than from other physicians; duration of the disease was found to predispose to SCC development. CONCLUSIONS: Our findings highlighted several gender differences on clinical presentation and symptom profile of GLS. In spite of some characteristic features, misdiagnosis at referrals was frequent.
BACKGROUND: Studies specifically conducted to assess gender differences in genital lichen sclerosus (GLS) are not available. This multicenter study aimed to identify possible gender-related differences on GLS clinical features, history and course, through collecting data from a large mixed-sex sample of patients. METHODS: This was a cross-sectional study on 729 subjects (53.8% females, 46.2% males) affected with GLS, consecutively observed within a network of 15 Italian dermatology units. The following information was specifically collected: clinical features and severity of symptoms related to GLS, extragenital involvement, previous therapies, diagnostic suspicion at referral, type of referring physicians, development of genital squamous-cell carcinoma (SCC). RESULTS: Females complained of symptoms more frequent and severe than men; pallor and scarring-sclerosis-atrophy were the most frequent features without gender differences; itching-related signs were more frequent in females than in males as well as extragenital involvement; prior to receiving a definitive diagnosis, females received treatment more frequently than males; 40% of patients were referred with a misdiagnosis; the highest rate of correct suspected diagnosis at referral came from dermatologists than from other physicians; duration of the disease was found to predispose to SCC development. CONCLUSIONS: Our findings highlighted several gender differences on clinical presentation and symptom profile of GLS. In spite of some characteristic features, misdiagnosis at referrals was frequent.