Gunthert et al reported a clinical score for vulvar lichen sclerosus. This is useful for the diagnosis when a woman refuses biopsy. The authors are from the University of Bern in Switzerland.
Parameters:
(1) mucosal erosions
(2) hyperkeratosis of vulva and peritoneum
(3) fissures or crakcs (rhagades)
(4) adherence of the labia minora and majora (agglutination)
(5) stenosis
(6) mucosal atrophy
Grades: 0 (none or minimal), 1 (mild to moderate), 2 (severe)
Parameter
Finding
Grade
mucosal erosions
none
0
1 or 2 small erosions, barely detectable
1
>= 3 lesions with confluence, readily seen
2
hyperkeratosis
none
0
1- 10%
1
> 10%
2
fissures
none
0
posterior introitus
1
generalized
2
adherence of the labia minora and majora
none
0
partial
1
complete
2
stenosis
none
0
narrowing but able to pass 2 fingers
1
marked narrowing, unable to pass 2 fingers
2
mucosal atrophy
none
0
shrinkage of labia minora and clitoris
1
labia minora and clitoris no longer visible
2
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• A score >= 4 was considered lichen sclerosus if typical symptoms present (intractable itching, soresness, etc).
To read more or access our algorithms and calculators, please log in or register.
