VULVAR LICHEN-SCLEROSUS - IMMUNOHISTOLOGIC EVALUATION BEFORE AND AFTER THERAPY

In 20 women with vulvar lichen sclerosus (LS) we analyzed the immunohi stologic features of the dermal lymphoid infiltrate and the number of epidermal CD1a + cells (Langerhans cells). Activated (HLA-Dr+) T cells , associated with CD1a + accessory cells, were found in the dermis in all cases. The number of CD1a+ epidermal cells was increased, and the cells expressed strong HLA-DR+ staining. These findings suggest activa tion of the skin immune system in vulvar LS lesions. Conventional 2% t estosterone therapy failed to modify the immunohistologic features. Cl obetasol, 0.05%, application seemed more effective in down-regulating the skin's immune system activation profile.