Time to Diagnosis of Vulval Lichen Sclerosus: A Systematic Review of Literature

Authors: Dr Luveon Yu On Tang¹, Miss Rebecca Gibbs¹

1. Royal Free Hospital, Pond Street, London NW3 2QG

Aims and Objectives

•       To examine the duration of time from symptom onset to diagnosis in patients with vulvar lichen sclerosus (LS) described in existing literature

•        To explore the patients’ perception of delay in diagnosis

Methodology

•       The search terms (lichen sclerosus), (time) and (lichen sclerosus), (delay) and (lichen sclerosus) were usedwithin the search engines PubMed and Scopus, which generated 1007 records from 1980-2024

•       1 Cochrane review and 1 reference of references were also included

•       24 duplicates were removed and a total of 86 records were screened

•       77 records were excluded as they described management strategies of LS and conditions other than vulvar LS

Results

•       9 publications included information related to delay in diagnosis for LS

•       In 2 qualitative studies, patients described having experienced symptoms from ‘7 months’ to ‘15 years’ prior to their diagnosis¹

•       Using ‘the Vulval Quality of Life Index’ score, an Australian study reported poor quality of life among untreated women²

•       In a study that included 335 women with LS, those whose diagnoses were made in gynaecology/ dermatology clinics after referral from primary care were significantly older, compared to those who were diagnosed at sexual health clinics, where a significant proportion of patients self-referred

Conclusion

•       Current literature describes ‘difficulties in obtaining diagnosis’ reported by LS patients

•       Paucity of information relating to the duration from symptom onset to diagnosis of LS