{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:29:58Z","timestamp":1792715398675,"version":"4.5.0"},"reference-count":86,"publisher":"Deutscher Arzte-Verlag GmbH","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"DOI":"10.3238\/arztebl.2020.0126","type":"journal-article","created":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T09:41:17Z","timestamp":1581586877000},"source":"Crossref","is-referenced-by-count":26,"title":["Vulvar Pruritus\u2014Causes, Diagnosis and Therapeutic Approach"],"prefix":"10.3238","author":[{"given":"Linn","family":"W\u00f6lber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Prieske","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Mendling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Schmalfeldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-J\u00fcrgen","family":"Tietz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Jaeger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11437","published-online":{"date-parts":[[2020,2,21]]},"reference":[{"key":"10.3238\/arztebl.2020.0126_ref1","doi-asserted-by":"crossref","unstructured":"St\u00e4nder S, Zeidler C, Augustin M, et al.: S2k-Leitlinie zur Diagnostik und Therapie des chronischen Pruritus. JDDG: J Dtsch Dermatol Ges 2017; 15: 860\u201373","DOI":"10.1111\/ddg.13304_g"},{"key":"10.3238\/arztebl.2020.0126_ref2","doi-asserted-by":"crossref","unstructured":"Yosipovitch G, Bernhard JD: Chronic pruritus. N Engl J Med 2013; 368: 1625\u201334","DOI":"10.1056\/NEJMcp1208814"},{"key":"10.3238\/arztebl.2020.0126_ref3","unstructured":"Petersen EE: Chronischer Juckreiz im Genital. Ars Medici 2011; 13+14: 559\u201362."},{"key":"10.3238\/arztebl.2020.0126_ref4","doi-asserted-by":"crossref","unstructured":"Bohl T: Overview of vulvar pruritus through the life cycle. Clin Obstet Gynecol 2005; 48: 786\u2013807","DOI":"10.1097\/01.grf.0000179636.64663.e6"},{"key":"10.3238\/arztebl.2020.0126_ref5","doi-asserted-by":"crossref","unstructured":"Harlow BL, Wise LA, Stewart EG: Prevalence and predictors of chronic lower genital tract discomfort. Am J Obstet Gynecol 2001; 185: 545\u201350","DOI":"10.1067\/mob.2001.116748"},{"key":"10.3238\/arztebl.2020.0126_ref6","doi-asserted-by":"crossref","unstructured":"Lawrance N, Yell J: Vulvar rruritus. In: Bornstein J (eds.): Vulvar disease. Springer International Publishing AG, part of Springer Nature; 57\u201364","DOI":"10.1007\/978-3-319-61621-6_7"},{"key":"10.3238\/arztebl.2020.0126_ref7","doi-asserted-by":"crossref","unstructured":"Schmelz M: A neural pathway for itch. Nat Neurosci 2001; 4: 9\u201310","DOI":"10.1038\/82956"},{"key":"10.3238\/arztebl.2020.0126_ref8","doi-asserted-by":"crossref","unstructured":"Bautista DM, Wilson SR, Hoon MA: Why we scratch an itch: the molecules, cells and circuits of itch. Nat Neurosci 2014; 17: 175","DOI":"10.1038\/nn.3619"},{"key":"10.3238\/arztebl.2020.0126_ref9","doi-asserted-by":"crossref","unstructured":"Meerpohl JJ, Langer G, Perleth M, Gartlehner G, Kaminski-Hartenthaler A, Schunemann H: [GRADE guidelines: 3. Rating the quality of evidence (confidence in the estimates of effect)]. Z Evid Fortbild Qual Gesundhwes 2012; 106: 449\u201356","DOI":"10.1016\/j.zefq.2012.06.013"},{"key":"10.3238\/arztebl.2020.0126_ref10","doi-asserted-by":"crossref","unstructured":"van der Meijden WI, Boffa MJ, Ter Harmsel WA, et al.: 2016 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol 2017; 31: 925\u201341 CrossRef","DOI":"10.1111\/jdv.14096"},{"key":"10.3238\/arztebl.2020.0126_ref11","unstructured":"Cruickshank ME: Green top Guideline No.58. The Management of vulval skin disorders. Royal College of Obstetricians and Gynaecoogists. 2011. http:\/\/mrcog.womanhospital.cn\/ueditor\/php\/upload\/file\/20190821\/1566377001.pdf (last accessed on 28 December 2019)"},{"key":"10.3238\/arztebl.2020.0126_ref12","doi-asserted-by":"crossref","unstructured":"Lynch PJ: Lichen simplex chronicus (atopic\/neurodermatitis) of the anogenital region. Dermatologic Therapy 2004; 17: 8\u201319","DOI":"10.1111\/j.1396-0296.2004.04002.x"},{"key":"10.3238\/arztebl.2020.0126_ref13","doi-asserted-by":"crossref","unstructured":"D\u2018Antuono A, Bellavista S, Negosanti F, Zauli S, Baldi E, Patrizi A: Dermasilk briefs in vulvar lichen sclerosus: an adjuvant tool. J Low Genit Tract Dis 2011; 15: 287\u201391","DOI":"10.1097\/LGT.0b013e31821380a0"},{"key":"10.3238\/arztebl.2020.0126_ref14","doi-asserted-by":"crossref","unstructured":"Corazza M, Borghi A, Minghetti S, Toni G, Virgili A: Effectiveness of silk fabric underwear as an adjuvant tool in the management of vulvar lichen simplex chronicus: results of a double-blind randomized controlled trial. Menopause 2015; 22: 850\u20136","DOI":"10.1097\/GME.0000000000000410"},{"key":"10.3238\/arztebl.2020.0126_ref15","doi-asserted-by":"crossref","unstructured":"Ansari P: Pruritus ani. Clin Colon Rectal Surg 2016; 29: 38\u201342","DOI":"10.1055\/s-0035-1570391"},{"key":"10.3238\/arztebl.2020.0126_ref16","doi-asserted-by":"crossref","unstructured":"D\u2019Antuono A, Baldi E, Bellavista S, Banzola N, Zauli S, Patrizi A: Use of dermasilk briefs in recurrent vulvovaginal candidosis: safety and effectiveness. Mycoses 2012; 55: e85\u2013e9","DOI":"10.1111\/j.1439-0507.2011.02102.x"},{"key":"10.3238\/arztebl.2020.0126_ref17","doi-asserted-by":"crossref","unstructured":"Swamiappan M: Anogenital pruritus\u2014an overview. J Clin Diagn Res 2016; 10: WE01\u20133","DOI":"10.7860\/JCDR\/2016\/18440.7703"},{"key":"10.3238\/arztebl.2020.0126_ref18","doi-asserted-by":"crossref","unstructured":"Hundley JL, Yosipovitch G: Mirtazapine for reducing nocturnal itch in patients with chronic pruritus: a pilot study. J Am Acad Dermatol 2004; 50: 889\u201391","DOI":"10.1016\/j.jaad.2004.01.045"},{"key":"10.3238\/arztebl.2020.0126_ref19","doi-asserted-by":"crossref","unstructured":"Tennyson H, Levine N: Neurotropic and psychotropic drugs in dermatology. Dermatol Clin 2001; 19: 179\u201397","DOI":"10.1016\/S0733-8635(05)70239-4"},{"key":"10.3238\/arztebl.2020.0126_ref20","doi-asserted-by":"crossref","unstructured":"Mattle V, Seeber B, Ruth-Egger S, Zervomanolakis I, Wildt L: Die Behandlung des therapierefrakt\u00e4ren Pruritus vulvae mit Naltrexon, einem spezifischen Opiatantagonisten. Geburtshilfe Frauenheilkd 2008; 68: P40","DOI":"10.1055\/s-2008-1078327"},{"key":"10.3238\/arztebl.2020.0126_ref21","doi-asserted-by":"crossref","unstructured":"Mohammad Ali BM, Hegab DS, El Saadany HM: Use of transcutaneous electrical nerve stimulation for chronic pruritus. Dermatol Ther 2015; 28: 210\u20135","DOI":"10.1111\/dth.12242"},{"key":"10.3238\/arztebl.2020.0126_ref22","doi-asserted-by":"crossref","unstructured":"Yu C, Zhang P, Lv Z-T, et al.: Efficacy of acupuncture in itch: a systematic review and meta-analysis of clinical randomized controlled trials. Evid Based Complement Alternat Med 2015; 2015: 208690","DOI":"10.1155\/2015\/208690"},{"key":"10.3238\/arztebl.2020.0126_ref23","unstructured":"Deutsche Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe (DGGG), Arbeitsgemeinschaft f\u00fcr Infektionen und Infektionsimmunologie in der Gyn\u00e4kologie und Geburtshilfe (AGII), Deutsche Dermatologische Gesellschaft (DDG), Deutschsprachige Mykologische Gesellschaft (DMyKG): Die Vulvovaginalkandidose AWMF 013\/004 (S1+IDA) ); 2010."},{"key":"10.3238\/arztebl.2020.0126_ref24","doi-asserted-by":"crossref","unstructured":"Foxman B: Prevalence of recurrent vulvovaginal candidiasis in 5\u00a0European countries and the United States: results from an internet panel survey. Low Genit Tract 2012; 17: 1\u20136","DOI":"10.1097\/LGT.0b013e318273e8cf"},{"key":"10.3238\/arztebl.2020.0126_ref25","doi-asserted-by":"crossref","unstructured":"Mendling W: Guideline: Vulvovaginal candidosis (AWMF 015\/072), S2k (excluding chronic mucocutaneous candidosis). Mycoses 2015; 58 (S1): 1\u201315","DOI":"10.1111\/myc.12292"},{"key":"10.3238\/arztebl.2020.0126_ref26","doi-asserted-by":"crossref","unstructured":"Sherrard J, Wilson J, Donders G, Mendling W, Jensen JS: 2018\u00a0European (IUSTI\/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS 2018; 29: 1258\u201372","DOI":"10.1177\/0956462418785451"},{"key":"10.3238\/arztebl.2020.0126_ref27","doi-asserted-by":"crossref","unstructured":"Mendling W: Dyspareunie, Vulvodynie und Vestibulodynie: Schmerzen statt Lust. Gyn\u00e4kologie und Geburtshilfe 2019; 24: 24\u20137","DOI":"10.1007\/s15013-019-1728-7"},{"key":"10.3238\/arztebl.2020.0126_ref28","doi-asserted-by":"crossref","unstructured":"Mendling W: Gyn\u00e4kologische Infektionen. Frauenheilkunde Up2 Date. 2019; 13: 1\u201319","DOI":"10.1055\/a-0820-9192"},{"key":"10.3238\/arztebl.2020.0126_ref29","doi-asserted-by":"crossref","unstructured":"Sobel JD: Recurrent vulvovaginal candidiasis. Am J Obstet Gynecol 2016; 214: 15\u201321","DOI":"10.1016\/j.ajog.2015.06.067"},{"key":"10.3238\/arztebl.2020.0126_ref30","doi-asserted-by":"crossref","unstructured":"Tietz HJ: [Candida glabrata: pathogenicity and therapy update]. Hautarzt 2012; 63: 868\u201371","DOI":"10.1007\/s00105-012-2377-0"},{"key":"10.3238\/arztebl.2020.0126_ref31","doi-asserted-by":"crossref","unstructured":"Pappas PG, Kauffman CA, Andes DR, et al.: Clinical practice guideline for the management of candidiasis: 2016. Update by the infectious diseases society of America. Clin Infect Dis 2016; 62: e1\u2013e50","DOI":"10.1093\/cid\/civ933"},{"key":"10.3238\/arztebl.2020.0126_ref32","doi-asserted-by":"crossref","unstructured":"Spellberg BJ, Filler SG, Edwards JE, Jr.: Current treatment strategies for disseminated candidiasis. Clin Infect Dis 2006; 42: 244\u201351","DOI":"10.1086\/499057"},{"key":"10.3238\/arztebl.2020.0126_ref33","doi-asserted-by":"crossref","unstructured":"Safdar A, van Rhee F, Henslee-Downey JP, Singhal S, Mehta J: Candida glabrata and candida krusei fungemia after high-risk allogeneic marrow transplantation: no adverse effect of low-dose fluconazole prophylaxis on incidence and outcome. Bone Marrow Transplant 2001; 28: 873\u20138","DOI":"10.1038\/sj.bmt.1703252"},{"key":"10.3238\/arztebl.2020.0126_ref34","doi-asserted-by":"crossref","unstructured":"Kuse E-R, Chetchotisakd P, Cunha C, et al.: Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial. Lancet 2007; 369: 1519\u201327","DOI":"10.1016\/S0140-6736(07)60605-9"},{"key":"10.3238\/arztebl.2020.0126_ref35","doi-asserted-by":"crossref","unstructured":"Perlin DS: Current perspectives on echinocandin class drugs. Future Microbiol 2011; 6: 441\u201357","DOI":"10.2217\/fmb.11.19"},{"key":"10.3238\/arztebl.2020.0126_ref36","doi-asserted-by":"crossref","unstructured":"Oliveira ER, Fothergill A, Kirkpatrick WR, Patterson TF, Redding SW: Antifungal susceptibility testing of micafungin against candida glabrata isolates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105: 457\u20139","DOI":"10.1016\/j.tripleo.2007.12.003"},{"key":"10.3238\/arztebl.2020.0126_ref37","doi-asserted-by":"crossref","unstructured":"Sobel JD, Chaim W, Nagappan V, Leaman D: Treatment of vaginitis caused by candida glabrata: use of topical boric acid and flucytosine. Am J Obstet Gynecol 2003; 189: 1297\u2013300","DOI":"10.1067\/S0002-9378(03)00726-9"},{"key":"10.3238\/arztebl.2020.0126_ref38","doi-asserted-by":"crossref","unstructured":"Huttenhower C, Gevers D, Knight R, et al.: The Human Microbiome Project (HMP) Consortium. Structure, function and diversity of the healthy human microbiome. Nature 2012; 486: 207\u201314","DOI":"10.1038\/nature11234"},{"key":"10.3238\/arztebl.2020.0126_ref39","doi-asserted-by":"crossref","unstructured":"Petricevic L: Das vaginale Mikrobiom. Der Gyn\u00e4kologe 2019; 52: 10\u20135","DOI":"10.1007\/s00129-018-4380-8"},{"key":"10.3238\/arztebl.2020.0126_ref40","doi-asserted-by":"crossref","unstructured":"Ravel J, Gajer P, Abdo Z, et al.: Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci USA 2011; 108 (Suppl 1): 4680\u20137.","DOI":"10.1073\/pnas.1002611107"},{"key":"10.3238\/arztebl.2020.0126_ref41","doi-asserted-by":"crossref","unstructured":"Steyer GE: Das vaginale Mikrobiom. EHK 2017; 66: 44\u201350","DOI":"10.1055\/s-0043-101612"},{"key":"10.3238\/arztebl.2020.0126_ref42","doi-asserted-by":"crossref","unstructured":"Wilson BA, Thomas SM, Ho M: The human vaginal microbiome. Metagenomics of the Human Body. Springer Medizin 2011; 91\u2013115","DOI":"10.1007\/978-1-4419-7089-3_6"},{"key":"10.3238\/arztebl.2020.0126_ref43","doi-asserted-by":"crossref","unstructured":"Lamont RF, Sobel JD, Akins RA, et al.: The vaginal microbiome: new information about genital tract flora using molecular based techniques. BJOG 2011; 118: 533\u201349","DOI":"10.1111\/j.1471-0528.2010.02840.x"},{"key":"10.3238\/arztebl.2020.0126_ref44","doi-asserted-by":"crossref","unstructured":"Fettweis JM, Serrano MG, Girerd PH, Jefferson KK, Buck GA: A new era of the vaginal microbiome: advances using next-generation sequencing. Chem Biodivers 2012; 9: 965\u201376","DOI":"10.1002\/cbdv.201100359"},{"key":"10.3238\/arztebl.2020.0126_ref45","doi-asserted-by":"crossref","unstructured":"White BA, Creedon DJ, Nelson KE, Wilson BA: The vaginal microbiome in health and disease. Trends Endocrinol Metab 2011; 22: 389\u201393","DOI":"10.1016\/j.tem.2011.06.001"},{"key":"10.3238\/arztebl.2020.0126_ref46","doi-asserted-by":"crossref","unstructured":"Sobel JD, Chaim W: Vaginal microbiology of women with acute recurrent vulvovaginal candidiasis. J Clin Microbiol 1996; 34: 2497\u20139","DOI":"10.1128\/jcm.34.10.2497-2499.1996"},{"key":"10.3238\/arztebl.2020.0126_ref47","doi-asserted-by":"crossref","unstructured":"Ehrstr\u00f6m S, Daroczy K, Rylander E, et al.: Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis. Microbes and Infection 2010; 12: 691\u20139","DOI":"10.1016\/j.micinf.2010.04.010"},{"key":"10.3238\/arztebl.2020.0126_ref48","doi-asserted-by":"crossref","unstructured":"Martinez RCR, Franceschini SA, Patta MC, et al.: Improved treatment of vulvovaginal candidiasis with fluconazole plus probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. Lett Appl Microbiol 2009; 48: 269\u201374","DOI":"10.1111\/j.1472-765X.2008.02477.x"},{"key":"10.3238\/arztebl.2020.0126_ref49","doi-asserted-by":"crossref","unstructured":"Mendling W: Vaginal microbiota. In: Schwiertz A, (ed.): Microbiota of the human body: implications in health and disease. Cham: Springer International Publishing 2016, 83\u201393","DOI":"10.1007\/978-3-319-31248-4_6"},{"key":"10.3238\/arztebl.2020.0126_ref50","doi-asserted-by":"crossref","unstructured":"Hilton E, Isenberg HD, Alperstein P, France K, Borenstein MT: Ingestion of yogurt containing lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med 1992; 116: 353\u20137","DOI":"10.7326\/0003-4819-116-5-353"},{"key":"10.3238\/arztebl.2020.0126_ref51","unstructured":"DIMDI: Fachinformation Gynatren. https:\/\/portal.dimdi.de\/amispb\/doc\/pei\/Web\/2602489-palde-20100301.pdf (last accessed on 29 January 2020)."},{"key":"10.3238\/arztebl.2020.0126_ref52","doi-asserted-by":"crossref","unstructured":"Siboulet A: Impfung gegen nichtspezifische bakterielle Vaginose. Doppelblinduntersuchung von Gynatren. Gynakol Geburtshilfliche Rundsch 1991; 31: 153\u201360","DOI":"10.1159\/000271648"},{"key":"10.3238\/arztebl.2020.0126_ref53","doi-asserted-by":"crossref","unstructured":"Alderete JF: Does lactobacillus vaccine for trichomoniasis, Solco Trichovac, induce antibody reactive with Trichomonas vaginalis? Genitourin Med 1988; 64: 118\u201323","DOI":"10.1136\/sti.64.2.118"},{"key":"10.3238\/arztebl.2020.0126_ref54","doi-asserted-by":"crossref","unstructured":"Cuzick J, Szarewski A, Cubie H, et al.: Management of women who test positive for high-risk types of human papillomavirus: the HART study. Lancet 2003; 362: 1871\u20136","DOI":"10.1016\/S0140-6736(03)14955-0"},{"key":"10.3238\/arztebl.2020.0126_ref55","doi-asserted-by":"crossref","unstructured":"Kirtschig G, Becker K, G\u00fcnthert A, et al.: Evidence-based (S3) guideline on (anogenital) Lichen sclerosus. J Eur Acad Dermatol Venereol 2015; 29: e1\u2013e43","DOI":"10.1111\/jdv.13136"},{"key":"10.3238\/arztebl.2020.0126_ref56","doi-asserted-by":"crossref","unstructured":"Thomas RHM, Kennedy CTC: The development of lichen sclerosus et atrophicus in monozygotic twin girls. Br J Dermatol 1986; 114: 377\u20139","DOI":"10.1111\/j.1365-2133.1986.tb02831.x"},{"key":"10.3238\/arztebl.2020.0126_ref57","doi-asserted-by":"crossref","unstructured":"Powell J, Wojnarowska F: Childhood vulvar lichen sclerosus: an increasingly common problem. J Am Acad Dermatol 2001; 44: 803\u20136","DOI":"10.1067\/mjd.2001.113474"},{"key":"10.3238\/arztebl.2020.0126_ref58","doi-asserted-by":"crossref","unstructured":"Sherman V, McPherson T, Baldo M, Salim A, Gao X, Wojnarowska F: The high rate of familial lichen sclerosus suggests a genetic contribution: an observational cohort study. J Am Acad Dermatol Venereol 2010; 24: 1031\u20134","DOI":"10.1111\/j.1468-3083.2010.03572.x"},{"key":"10.3238\/arztebl.2020.0126_ref59","doi-asserted-by":"crossref","unstructured":"Purcell KG, Spencer LV, Simpson PM, Helman SW, Oldfather JW, Fowler JF Jr.: HLA antigens in lichen sclerosus et atrophicus. Arch Dermatol 1990; 126: 1043\u20135","DOI":"10.1001\/archderm.126.8.1043"},{"key":"10.3238\/arztebl.2020.0126_ref60","doi-asserted-by":"crossref","unstructured":"Marren P, Jell J, Charnock FM, Bunce M, Welsh K, Wojnarowska F: The association between lichen sclerosus and antigens of the HLA system. Br J Dermatol 1995; 132: 197\u2013203","DOI":"10.1111\/j.1365-2133.1995.tb05013.x"},{"key":"10.3238\/arztebl.2020.0126_ref61","doi-asserted-by":"crossref","unstructured":"Powell J, Wojnarowska F, Winsey S, Marren P, Welsh K: Lichen sclerosus premenarche: autoimmunity and immunogenetics. Br J Dermatol 2000; 142: 481\u20134","DOI":"10.1046\/j.1365-2133.2000.03360.x"},{"key":"10.3238\/arztebl.2020.0126_ref62","doi-asserted-by":"crossref","unstructured":"Gross T, Wagner A, Ugurel S, Tilgen W, Reinhold U: Identification of TIA-1+ and Granzyme B+ cytotoxic T cells in Lichen sclerosus et atrophicus. Dermatology 2001; 202: 198\u2013202","DOI":"10.1159\/000051636"},{"key":"10.3238\/arztebl.2020.0126_ref63","doi-asserted-by":"crossref","unstructured":"Carlson JA, Grabowski R, Chichester P, Paunovich E, Malfetano J: Comparative immunophenotypic study of lichen sclerosus: Epidermotropic CD57+ lymphocytes are numerous\u2014implications for pathogenesis. Am J Dermatopathol 2000; 22: 7\u201316","DOI":"10.1097\/00000372-200002000-00002"},{"key":"10.3238\/arztebl.2020.0126_ref64","doi-asserted-by":"crossref","unstructured":"Kreuter A, Kryvosheyeva Y, Terras S, et al.: Association of autoimmune diseases with lichen sclerosus in 532 male and female patients. Acta Derm Venereol 2013; 93: 238\u201341","DOI":"10.2340\/00015555-1512"},{"key":"10.3238\/arztebl.2020.0126_ref65","doi-asserted-by":"crossref","unstructured":"Cooper SM, Ali I, Baldo M, Wojnarowska F: The association of lichen sclerosus and erosive lichen planus of the vulva with autoimmune disease: a case-control study. Arch Dermatol 2008; 144: 1432\u20135","DOI":"10.1001\/archderm.144.11.1432"},{"key":"10.3238\/arztebl.2020.0126_ref66","doi-asserted-by":"crossref","unstructured":"Thomas RHM, Ridley CM, Mcgibbon DH, Black MM: Lichen sclerosus et atrophicus and autoimmunity\u2014a study of 350 women. Br J Dermatol 1988; 118: 41\u20136","DOI":"10.1111\/j.1365-2133.1988.tb01748.x"},{"key":"10.3238\/arztebl.2020.0126_ref67","doi-asserted-by":"crossref","unstructured":"Oyama N, Chan I, Neill SM, et al.: Autoantibodies to extracellular matrix protein 1 in lichen sclerosus. The Lancet 2003; 362: 118\u201323","DOI":"10.1016\/S0140-6736(03)13863-9"},{"key":"10.3238\/arztebl.2020.0126_ref68","doi-asserted-by":"crossref","unstructured":"Gambichler T, Skrygan M, Tigges C, Kobus S, Gl\u00e4ser R, Kreuter A: Significant upregulation of antimicrobial peptides and proteins in lichen sclerosus. Br J Dermatol 2009; 161: 1136\u201342","DOI":"10.1111\/j.1365-2133.2009.09273.x"},{"key":"10.3238\/arztebl.2020.0126_ref69","doi-asserted-by":"crossref","unstructured":"Howard A, Dean D, Cooper S, Kirtshig G, Wojnarowska F: Circulating basement membrane zone antibodies are found in lichen sclerosus of the vulva. Australas J Dermatol 2004; 45: 12\u20135","DOI":"10.1111\/j.1440-0960.2004.00026.x"},{"key":"10.3238\/arztebl.2020.0126_ref70","doi-asserted-by":"crossref","unstructured":"Strittmatter HJ, Hengge UR, Blecken SR: Calcineurin antagonists in vulvar lichen sclerosus. Arch Gynecol Obstet 2006; 274: 266\u201370","DOI":"10.1007\/s00404-006-0151-1"},{"key":"10.3238\/arztebl.2020.0126_ref71","doi-asserted-by":"crossref","unstructured":"Chan I, Oyama N, Neill SM, Wojnarowska F, Black MM, McGrath JA: Characterization of IgG autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Clin Exp Dermatol 2004; 29: 499\u2013504","DOI":"10.1111\/j.1365-2230.2004.01573.x"},{"key":"10.3238\/arztebl.2020.0126_ref72","doi-asserted-by":"crossref","unstructured":"Eisendle K, Grabner T, Kutzner H, Zelger B: Possible role of borrelia burgdorferi sensu lato infection in lichen sclerosus. Arch Dermatol 2008; 144: 591\u20138","DOI":"10.1001\/archderm.144.5.591"},{"key":"10.3238\/arztebl.2020.0126_ref73","doi-asserted-by":"crossref","unstructured":"Powell J, Strauss S, Gray J, Wojnarowska F: Genital carriage of human papilloma virus (HPV) DNA in prepubertal girls with and without vulval disease. Pediatr Dermatol 2003; 20: 191\u20134","DOI":"10.1046\/j.1525-1470.2003.20301.x"},{"key":"10.3238\/arztebl.2020.0126_ref74","doi-asserted-by":"crossref","unstructured":"Aid\u00e9 S, Lattario FR, Almeida G, do Val IC, da Costa Carvalho M: Epstein-barr virus and human papillomavirus infection in vulvar lichen sclerosus. J Low Genit Tract Dis 2010; 14: 319\u201322","DOI":"10.1097\/LGT.0b013e3181d734f1"},{"key":"10.3238\/arztebl.2020.0126_ref75","doi-asserted-by":"crossref","unstructured":"Farrell AM, Dean D, Millard PR, Charnock FM, Wojnarowska F: Cytokine alterations in lichen sclerosus: an immunohistochemical study. Br J Dermatol 2006; 155: 931\u201340","DOI":"10.1111\/j.1365-2133.2006.07414.x"},{"key":"10.3238\/arztebl.2020.0126_ref76","doi-asserted-by":"crossref","unstructured":"Smith YR, Haefner HK: Vulvar lichen sclerosus: pathophysiology and treatment. Am J Clin Dermatol 2004; 5: 105\u201325","DOI":"10.2165\/00128071-200405020-00005"},{"key":"10.3238\/arztebl.2020.0126_ref77","doi-asserted-by":"crossref","unstructured":"Schwegler J, Schwarz J, Eulenburg C, et al.: Health-related quality of life and patient-defined benefit of clobetasol 0,05% in women with chronic lichen sclerosus of the vulva. Dermatology 2011; 223: 152\u201360","DOI":"10.1159\/000332831"},{"key":"10.3238\/arztebl.2020.0126_ref78","unstructured":"Dalziel KL, Wojnarowska F: Long-term control of vulval lichen sclerosus after treatment with a potent topical steroid cream. J Reprod Med 1993; 38: 25\u20137."},{"key":"10.3238\/arztebl.2020.0126_ref79","doi-asserted-by":"crossref","unstructured":"Lee A, Bradford J, Fischer G: Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women. JAMA Dermatology 2015; 151: 1061\u20137","DOI":"10.1001\/jamadermatol.2015.0643"},{"key":"10.3238\/arztebl.2020.0126_ref80","doi-asserted-by":"crossref","unstructured":"Luesley D, Downey G: Topical tacrolimus in the management of lichen sclerosus. BJOG 2006; 113: 832\u20134","DOI":"10.1111\/j.1471-0528.2006.00977.x"},{"key":"10.3238\/arztebl.2020.0126_ref81","doi-asserted-by":"crossref","unstructured":"Kirtschig G, Becker K, G\u00fcnthert A, et al.: Evidence-based (S3) guideline on (anogenital) Lichen sclerosus. J Eur Acad Dermatol Venereol 2015; 29: e","DOI":"10.1111\/jdv.13136"},{"key":"10.3238\/arztebl.2020.0126_ref82","doi-asserted-by":"crossref","unstructured":"Eberz S, Regauer S: H\u00e4ufigkeit von vaginalen Neoplasien bei anogenitalem Lichen planus. Geburtshilfe Frauenheilkd 2009; 69: A018","DOI":"10.1055\/s-0029-1238938"},{"key":"10.3238\/arztebl.2020.0126_ref83","unstructured":""},{"key":"10.3238\/arztebl.2020.0126_ref84","doi-asserted-by":"crossref","unstructured":"Eberz B, Regauer S: Assoziation von anogenitalem Lichen sclerosus und Psoriasis bei erwachsenen Frauen. Geburtshilfe Frauenheilkd 2008; 68; 32","DOI":"10.1055\/s-2008-1078319"},{"key":"10.3238\/arztebl.2020.0126_ref85","doi-asserted-by":"crossref","unstructured":"Gibbon K: Atopic eczema, lichen simplex and seborrheic dermatitis. In: Kirtschig G, Cooper S: Gynecologic dermatology\u2014symptoms, signs and clinical management. 2016; 65\u20139","DOI":"10.5005\/jp\/books\/12885_17"},{"key":"10.3238\/arztebl.2020.0126_ref86","doi-asserted-by":"crossref","unstructured":"Stockdale CK, Boardman L: Diagnosis and treatment of vulvar dermatoses. Obstet Gynecol. 2018 ;131: 371\u201386","DOI":"10.1097\/AOG.0000000000002460"}],"container-title":["Deutsches \u00c4rzteblatt international"],"original-title":[],"link":[{"URL":"https:\/\/www.aerzteblatt.de\/10.3238\/arztebl.2020.0126","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T09:51:31Z","timestamp":1638784291000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.aerzteblatt.de\/10.3238\/arztebl.2020.0126"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,21]]},"references-count":86,"URL":"https:\/\/doi.org\/10.3238\/arztebl.2020.0126","relation":{},"ISSN":["1866-0452"],"issn-type":[{"value":"1866-0452","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,21]]}}}