The effects of lichen sclerosus and its treatments on sexuality : case report

Abstract

Lichen sclerosus is a chronic and autoimmune dermatitis that develops in the anogenital region. It is related to genital alterations with repercussions in sexuality. We present a case of a 60-year-old woman who had several chronic diseases and had been diagnosed with vulvar lichen sclerosusfor 20 years, with no response to multiple treatments (topical corticosteroids, immuno-modulators). She was submitted to vulvectomy; however, it leads to worsen-ing of her condition, presenting obliterated and fibrosed clitoris, atrophic va-ginal lips, and anal and vulvar fissures. She remained with dyspareunia, de-creased sexual desire and difficulty in orgasm. She underwent sexual therapy, adjustment of antidepressant medication and made intercalated use of topical corticosteroids, topical testosterone andvaginal moisturizers, with partial improvement. From this case we can conclude that, although vulvectomy can be related to some degree of improvement in patients with lichen sclerosus, serious complications can occur.