Visser, Emma (2025) VULVAR HIGH-GRADE SQUAMOUS INTRAEPITHELIAL LESION IN WOMEN WITH VULVAR LICHEN SCLEROSUS: A POSSIBLE ROLE FOR CORTICOSTEROID USE? A retrospective analysis. thesis, Medicine.
Full text available on request.Abstract
Introduction: Two distinct etiological pathways contribute to the development of vulvar squamous cell carcinoma (VSCC): the high-risk human papillomavirus (hrHPV)-dependent pathway associated with vulvar high-grade squamous intraepithelial lesion (vHSIL) and the hrHPV-independent pathway associated with differentiated vulvar intraepithelial neoplasia (dVIN) and lichen sclerosus (LS). Clinical observations indicate an escalating prevalence of vHSIL in women diagnosed with LS. It is hypothesised that corticosteroid treatment for LS may result in the suppression of local immunity, thereby enabling hrHPV to persist. This study aims to investigate the prevalence of LS in women diagnosed with vHSIL and to explore a potential association between the use of vulvar corticosteroids and the development of vHSIL. Methods: This retrospective case series includes patients diagnosed with vHSIL between 2018 and 2024. The prevalence of LS and the use of vulvar corticosteroids at the time of vHSIL diagnosis are analysed and compared with a matched control group of women who underwent removal of a benign endometrial polyp. Results: A total of 41 patients diagnosed with vHSIL are included in the study. LS is present in 37.5%, and 32.5% of patients use vulvar corticosteroids at the time of diagnosis. In contrast, the prevalence of LS and corticosteroid use in the control group (n = 421) is significantly lower, at 2.6% and 2.1%, respectively. This difference is statistically significant (p < .001). Multivariable logistic regression analysis reveals a significant association between smoking and reduced odds of corticosteroid use (p = 0.028). Conclusion: This study demonstrates a significant association between LS and vHSIL, with increased corticosteroid use observed among vHSIL patients. This finding suggests a relation between corticosteroid use and the development of vHSIL.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Louwers, Dr. Jacqueline and Vernooij, Dr. Floor |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 May 2026 12:43 |
| Last Modified: | 19 May 2026 12:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3955 |
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