Hidradenitis Suppurativa and Vulvar Lichen Sclerosus: a Case Series

Purpose

Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease associated with many cutaneous comorbidities, including acne, dissecting cellulitis of the scalp, pilonidal cysts, and pyoderma gangrenosum (1-4). Although there is a plethora of literature on HS comorbidities, the association between HS and vulvar lichen sclerosus (VLS) needs further investigation. To date, two cases have been reported of HS and VLS in Caucasian women in their 4th to 6th decade of life (5). This study describes a series of 27 women with HS and VLS.

Methods

Retrospective review of 27 female patients diagnosed with HS, identified by ICD-10 code L73.2, and comorbid VLS, identified by ICD-10 code L90.0, who presented to Northwestern Dermatology between October 2015 - December 2023. Demographic variables of age, sex, and race were extracted for all included patients.

Results

Out of 27 female patients, 74.1% identified as white, 7.4% identified as black, and 18.5% declined to respond. The mean age was 57.1 years old (SD 17.2). All patients were either diagnosed with HS first (15/27) or HS and VLS simultaneously (12/27). For the 15 patients diagnosed with HS first, the average time between HS and VLS diagnosis was 25.1 months (2.09 years).

Conclusion

We present a cohort of patients with HS and VLS, two chronic inflammatory conditions that often present unique challenges in diagnosis and management. Providers caring for patients with HS may consider screening for VLS. This is especially pertinent as both diseases are associated with an increased risk of cutaneous squamous cell carcinoma (6-7).