Pathological processes of the cervix in lichen sclerosus of the vulva

Background. Taking into account the possible unity of etiopathogenetic mechanisms causing dysplastic processes of the cervix and vulva, one of the factors leading to synchronous damage to the cervix and external genitalia may be microbial-viral associations from the group of STIs. Aims. Clinical and instrumental characteristics and evaluation of the microbial composition of clinical material obtained from the cervix and vulva in patients with vulvar lichen sclerosus (VLS) and their treatment. Materials and methods. The study included 22 patients aged from 23 to 68 years with a diagnosis of VLS, who underwent microbiological, PCR studies, cutometry, corneometry, sebumetry, dermatoscopy, colposcopy. Results. Simultaneous damage to the vulva and cervix occurred in 16 (72.7%) patients: in the form of cervical erosions and ectopia in 7 (31.8%); grade I–II dysplasia — 4 (18.2%); leukoplakia — 3 (13.6%); cervical polyps — 2 (9.1%). In 6 (27.3%) cases, the presence of human papillomavirus (HPV) 16/18 was noted, among these patients, HPV 16/18 was also detected in a vulvar biopsy in 4 (18.2%) women. Also, other types of HPV were detected in biopsies of the vulva in 9 (40.9%) patients: HPV 35 was detected in 4 patients (18.2%); HPV 6/11 — in 3 (13.6%); HPV 53 — in 2 (9.1%). Conclusion. In patients with VLS, there is an increased frequency of dysplastic and dystrophic lesions of the cervix, such as erosions and ectopia of the cervix (31.8%), grade I–II dysplasia (18.2%), leukoplakia (13.6%), as well as an increased frequency of infections such as Ureaplasma Urealyticum (50.0%), HPV 16/18 (27.3%), HSV I type (36.4%), HSV II type (31.8%), as well as Gardnerella vaginalis (41.0%) and Candida spp. (45.5%), which can be a trigger for the development of dystrophic and dysplastic processes not only of the vulva, but also of the cervix.