Prior anogenital herpes and human papillomavirus infections are associated with increased risk of lichen sclerosus in a large retrospective cohort study.

BACKGROUND

Lichen sclerosus (LS) is an inflammatory mucocutaneous disorder typically affecting the anogenital region with unknown etiology. It is postulated that infectious etiologies could play a role in pathogenesis.

OBJECTIVE

Herein, we analyze for potential associations between LS and infectious agents.

METHODS

The TriNetX research network was utilized to compare prevalence of prior infections in patients with versus without LS and risk of LS in patients with versus without prior infections.

RESULTS

Patients with versus without LS had a higher prevalence of prior herpes simplex virus (HSV), human papillomavirus (HPV), gonorrhea, chlamydia, Lyme disease, hepatitis B virus, and hepatitis C virus diagnosis. Preceding infections with HSV and HPV were associated with increased risk of developing LS. Preceding vaccination for HPV was associated with decreased risk of LS.

LIMITATIONS: We were limited to ICD-10 codes and their accuracy. We could not confirm LS histopathologically, separate genital and extragenital LS, or assess specific HPV types.

CONCLUSION

Our study suggests that HSV and HPV infections may be potential LS risk factors.