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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
ArchiveEthical StandardsSubscription
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InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
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Obstetrics and Gynegology2026№2

Management of patients with vulvar lichen sclerosus: diagnosis and therapy optimization with topical glucorticosteroids

DOI
https://dx.doi.org/10.18565/aig.2025.376

Balashova Kh.B., Apolikhina I.A.

1) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia

Vulvar lichen sclerosus (VLS) is one of the most difficult chronic dermatoses in the anogenital area for diagnosis and treatment. It is necessary for a clinician to have a comprehensive understanding of pathogenesis, clinical manifestations, and principles of long-term therapy. The article provides a synthesis of the latest findings on VLS, including descriptions of current concepts of pathogenesis, key clinical manifestations, psychosexual consequences, and comorbidity. Special attention is paid to practical aspects of diagnosis, issues of long-term therapy with glucocorticosteroids (GCS), differences between ointment and cream with GCS, principles of dosing and factors influencing the adherence of patients to therapy.
The presented data emphasize the importance of early detection of VLS, competent interpretation of clinical and morphological signs, and the rational use of topical GCS as a basic therapy. These findings can help reduce the risk of inflammation, scarring, and vulvar intraepithelial neoplasia, as well as improve women’s quality of life.
Conclusion: Effective and safe management of patients with VLS is impossible without accurate and timely diagnosis based on the detection of early clinical signs and morphological confirmation of this disease. The educational component is essential: patients should be given clear instructions on how to use topical GCS, including information about dosage, application techniques, and the need for long-term maintenance therapy. Explaining to patients the risk factors for VLS, the importance of intimate hygiene, and following the proper practices for taking GCS increases adherence to treatment, reduces the risk of both insufficient and excessive use of the medication, and directly affects clinical outcomes.

Authors’ contributions: Balashova Kh.B. – collecting publications, translation of the articles, processing and analysis of materials, writing the text; Apolikhina I.A. – developing the concept of the study and editing the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Balashova Kh.B., Apolikhina I.A. Management of patients with vulvar lichen sclerosus:
diagnosis and therapy optimization with topical glucorticosteroids.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (2): 24-30 (in Russian)
https://dx.doi.org/10.18565/aig.2025.376

Keywords

vulvar lichen sclerosus
pathogenesis
clinical diagnosis
dermatoscopy
biopsy
topical glucocorticosteroids
clobetasol
dosage
adherence to treatment
quality of life
Full text (in Russian)

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Received 17.12.2025

Accepted 15.01.2026

About the Authors

Khava B. Balashova, оbstetrician-gynecologist, Postgraduate, Department of Aesthetic Gynecology and Rehabilitation, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4, Ac. Oparina str., Moscow, 117997, Russia, +7(925)186-43-88, Hava199@mail.ru,
https://orcid.org/0000-0003-3365-4695
Inna A. Apolikhina, Dr. Med. Sci., Professor, Honored Doctor of the Russian Federation, Head of the Department of Aesthetic Gynecology and Rehabilitation, Professor at the Department of Obstetrics and Gynecology, Department of Vocational Education, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4, Ac. Oparina str., Moscow, 117997, Russia; Professor at the Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); President of the Association of Aesthetic Gynecology Specialists, i_apolikhina@oparina4.ru, https://orcid.org/0000-0002-4581-6295
Corresponding author: Khava B. Balashova, Hava199@mail.ru

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