Clinical Scoring System for Vulvar Lichen Sclerosus

ABSTRACTIntroductionVulvar lichen sclerosus (LS) is a chronic inflammatory and mutilating disease, which goes often undetected for years. Advanced disease severely affects quality of life like sexual disorders and is also associated with an increased risk of vulvar cancer.AimTo develop and validate a patient‐administered symptom score and a physician‐administered clinical score for the diagnosis and evaluation of vulvar LS.MethodsWe included 24 patients with established LS diagnosis and 49 with other vulvar disease. The physician‐administered score was based on six clinical features and the patient‐administered score was a symptom‐based four‐item composite score. We determined inter‐item correlations and internal consistency of both scores, and estimated sensitivities, specificities, likelihood ratios, and posttest probabilities for different cutoffs of the physician‐administered score.Main Outcome MeasuresCharacteristics of patients with and without LS were compared using χ2 and unpaired t‐test as required. We then determined Cronbach's alpha as a measure of the overall consistency of scores and calculated positive and negative likelihoods.ResultsLack of redundancy of items (correlation coefficients < 0.90) and internal consistency (Cronbach's α≥ 0.70) suggested that final composite scores were valid and yielded excellent power to rule in LS.ConclusionScores may be useful for assessing symptoms of vulvar disorders, to ease diagnosis of LS and to evaluate treatment response over time. Günthert AR, Duclos K, Jahns BG, Krause E, Amann E, Limacher A, Mueller MD, and Jüni P. Clinical scoring system for vulvar lichen sclerosus. J Sex Med 2012;9:2342–2350.