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

Overview

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.