Correlation between serum sex hormone levels and severity of disease in female patients with vulvar lichen sclerosus

ZHU Li-hong; ZHAO Shu-zhen; WANG Yu-hong; QIN Hai-xia; HOU Rui-jie; WANG Yuan-yuan; LI Min

doi:10.3969/j.issn.1674-8468.2019.01.005

Abstract：Objective:To investigate the correlation between serum sex hormone levels and severity of disease in female patients with vulvar lichen sclerosus.Methods:We retrospectively analyzed clinical data from 45 healthy controls and 49 female patients with vulvar lichen sclerosus who visited our hospital from January 2016 to June 2018. Serum levels of sex hormones were compared between the two groups. Pearson analysis was used to assess the correlation between serum sex hormone levels and the scores of area of vulvar leukoplakia and extent of pruritus. Results:The vulvar leukoplakias were primarily located on the labia majora, labia minora, meatus urinarius and clitoris in patients with vulvar lichen sclerosus. Regarding disease severity based on the size of vulvar leukoplakia, 67.35％ of patients (33/49) were mild. Thirty two out of 49 patients (65.30％) exhibited mild pruritus. The scores of area and pruritus of vulva leukoplakia were 4.12±0.53 and 1.18±0.67, respectively. Serum levels of both dihydrotestosterone and estradiol in patients with vulva lichen sclerosus were significantly lower than that in normal controls (P<0.05). Moreover, serum levels of dihydrotestosterone and estradiol in recurrent patients with vulvar lichen sclerosus were significantly lower than that in primary patients (dihydrotestosterone: 0.09±0.01 vs 0.15±0.07 nmol/L;estradiol: 17.35±6.13 vs 23.58±3.48 pg/mL) (all P<0.05). Finally, serum levels of both dihydrotestosterone and estradiol correlated negatively with the area scores of vulvar leukoplakia (r=-0.78 for dihydrotestosterone and r=-0.21 for estradiol) (all P<0.05). Conclusions:Serum sex hormone levels correlate negatively with disease severity of vulvar lichen sclerosus. Low levels of dihydrotestosterone and estradiol are associated with relapse of vulvar lichen sclerosus.