Vulvar lichen sclerosus (VLS) is a progressive skin disease of unknown etiology. In this longitudinal case-control exploratory study, we evaluated the hormonal and microbial landscapes in 18 postmenopausal women (mean [SD] age: 64.4 [8.4] years) with VLS and controls. We reevaluated the patients with VLS after 10–14 weeks of daily topical class I steroid. We found that groin cutaneous estrone was lower in VLS than in controls (−22.33, 95% confidence interval [CI] = −36.96 to −7.70; = .006); cutaneous progesterone was higher (5.73, 95% CI = 3.74–7.73; .0001). Forehead 11-deoxycortisol (−0.24, 95% CI = −0.42 to −0.06; .01) and testosterone (−7.22, 95% CI = −12.83 to −1.62; = .02) were lower in disease. With treatment, cutaneous estrone (−7.88, 95% CI = −44.07 to 28.31; = .62), progesterone (2.02, 95% CI = −2.08 to 6.11; = .29), and 11-deoxycortisol (−0.13, 95% CI = −0.32 to 0.05; = .15) normalized; testosterone remained suppressed (−7.41, 95% CI = −13.38 to −1.43; = .02). 16S ribosomal RNA V1–V3 and ITS1 amplicon sequencing revealed bacterial and fungal microbiome alterations in disease. Findings suggest that cutaneous sex hormone and bacterial microbiome alterations may be associated with VLS in postmenopausal women.

中文翻译：

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外阴硬化性苔藓皮肤激素景观和微生物组的评估

外阴硬化性苔藓（VLS）是一种病因不明的进行性皮肤病。在这项纵向病例对照探索性研究中，我们评估了 18 名绝经后女性（平均 [SD] 年龄：64.4 [8.4] 岁）接受 VLS 和对照组的荷尔蒙和微生物状况。在每天局部使用 I 类类固醇 10-14 周后，我们重新评估了 VLS 患者。我们发现 VLS 中的腹股沟皮肤雌酮低于对照组（−22.33，95% 置信区间 [CI] = -36.96 至 -7.70；= .006）；皮肤黄体酮较高（5.73，95% CI = 3.74–7.73；.0001）。前额11-脱氧皮质醇（-0.24，95% CI = -0.42 至 -0.06；.01）和睾酮（-7.22，95% CI = -12.83 至 -1.62；= .02）在疾病中较低。治疗后，皮肤雌酮（-7.88，95% CI = -44.07至28.31；= .62）、黄体酮（2.02，95% CI = -2.08至6.11；= .29）和11-脱氧皮质醇（-0.13，95） % CI = -0.32 至 0.05；= .15) 标准化；睾酮仍然受到抑制（-7.41，95% CI = -13.38 至 -1.43；= .02）。16S 核糖体 RNA V1-V3 和 ITS1 扩增子测序揭示了疾病中细菌和真菌微生物组的变化。研究结果表明，皮肤性激素和细菌微生物组的改变可能与绝经后女性的 VLS 相关。