Microbiome Dysbiosis in Lichen Sclerosus: A Systematic Review
Bibliographic record
Abstract
Background: Lichen sclerosus (LS) is a chronic, inflammatory skin condition primarily affecting the vulvar and perineal areas, often causing pain, pruritus, and scarring. While vulvar and vaginal microbiome composition is understood to contribute to genital health, their relationship with LS pathogenesis is unclear. Recent studies also suggest that gut microbiome imbalances may influence LS via systemic immune modulation. This systematic review aimed to characterize microbial alterations in the vulvar, vaginal, and gut microbiomes of LS patients and explore potential mechanisms linking dysbiosis to disease progression. Methods: A systematic search was conducted using five databases: EMBASE, Medline via Ovid, Web of Science, PubMed, and CINAHL. Eligible studies included female patients diagnosed with LS and assessed the primary outcome of vulvar and vaginal microbiome composition. Gut microbiome data were considered a secondary outcome of interest. Following an initial double-blind screening, eight full-text articles were reviewed in the secondary screening, and seven articles were ultimately included in this review. Results: Seven studies met the inclusion criteria. Across the vulvar, vaginal, and gut microbiomes, consistent patterns emerged, including reductions in protective taxa, such as Firmicutes and Lactobacillus, and increases in pro-inflammatory microbes, including Proteobacteria. Vulvar samples also showed higher abundances of Enterobacteriaceae, Peptoniphilus, and Campylobacter. Gut microbiome alterations included reduced short-chain fatty acid-producing bacteria, such as Firmicutes and Bacteroides, in addition to elevated Proteobacteria and Rikenellaceae. Alpha diversity findings were variable, and species-level changes were often inconsistent. Conclusions: Microbial dysbiosis of the vulvar, vaginal, and gut microbiomes may contribute to the development of LS through chronic inflammation, compromised epithelial barriers, and disrupted immune function. While some alterations in the microbiomes were identified, discrepancies between the results of these studies highlight the need for larger, standardized studies to better understand the relationship between the microbiome and LS pathophysiology.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".