Lichen sclerosus in cancer patients Journal Article


Authors: Geisler, A. N.; Jain, S.; Roche, K. L.; Goldfrank, D. J.; Markova, A.; Lacouture, M. E.; Noor, S. J.
Article Title: Lichen sclerosus in cancer patients
Abstract: ObjectiveTo characterize the association between cancer therapies and the development of lichen sclerosus (LS) in a case series of patients.MethodsA retrospective chart review was performed to screen for patients who were diagnosed with LS while undergoing cancer therapy at Memorial Sloan Kettering Cancer Center between 2003 and 2019. Patients were excluded if they had been diagnosed with LS prior to starting cancer therapy. Clinical and treatment characteristics were analyzed.ResultsThe final study sample included 29 female patients who developed LS in the setting of systemic cancer therapy. Median time to LS onset after cancer therapy initiation was 420 days. Primary tumor types included breast (10, 34.5%), gynecologic (8, 27.6%), gastrointestinal (5, 17.2%), cutaneous (2, 6.9%), lung (2, 6.9%), and hematologic (2, 6.9%). Cancer therapy regimens included hormonal therapy (10, 34.5%), chemoradiation (7, 24.1%), cytotoxic chemotherapy (7, 24.1%), PD-1/PD-L1 inhibitors (3, 10.3%), local radiation (1, 3.4%), and allogeneic stem cell transplant (1, 3.4%). Across all patients, the mean number of treatments for LS was 2.8. Twenty-three (79.3%) patients received the first-line therapy of ultrapotent topical steroids, but 16 (69.6%) required additional topical and systemic treatment. Limitations include retrospective design and referral bias.ConclusionsBreast cancer was the most common primary tumor among patients in this study. The most common cancer therapy regimen was hormonal therapy. Most patients required an escalation in therapy to manage their LS. For patients undergoing cancer treatment, concomitant LS management can present unique challenges due to the biological mechanism of some anticancer therapies and the pathophysiology of LS. There is limited data to guide treatment of LS for this population. Some of the patients included in this analysis had progression of LS and recurrence of cancer while undergoing management of both conditions, necessitating close follow-up.
Keywords: aromatase inhibitor; immunotherapy; radiation therapy; hormonal therapy; chemoradiation; cytotoxic chemotherapy; immune checkpoint inhibitor; androgen receptors; lichen sclerosus; vulvar lichen sclerosus; extragenital lichen sclerosus
Journal Title: Journal of Lower Genital Tract Disease
Volume: 29
Issue: 2
ISSN: 1089-2591
Publisher: Lippincott Williams & Wilkins  
Date Published: 2025-04-01
Start Page: 186
End Page: 189
Language: English
ACCESSION: WOS:001449589000007
DOI: 10.1097/lgt.0000000000000870
PROVIDER: wos
PUBMED: 39912802
Notes: Article -- Source: Wos
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