BSV05 Vulval lichen simplex and markers of anaemia and vitamin D deficiency in an ethnically diverse population

Abstract

Vulval lichen simplex chronicus (VLSC) is a chronic, itchy inflammatory skin condition characterized by lichenified plaques secondary to persistent scratching. It can be secondary to an underlying skin condition, systemic disease or psychological condition. Asian and Black patients seem to have a higher prevalence. Our aim was to investigate the pathogenesis underlying VLSC, including underlying factors of atopy, iron deficiency and vitamin D deficiency in different ethnic groups. Retrospective case note examination was used to identify patients diagnosed with VLSC in a specialist vulval dermatology clinic from 2021 to 2024. Patients in the same clinic diagnosed with anogenital psoriasis were selected as controls. Statistical methods used for analysis included two-tailed t-test comparison. In total, 73 patients with VLSC were identified, along with 40 with anogenital psoriasis. Data collected included age, presence of atopy, documented ethnicity, serum vitamin D, haemoglobin, mean cell volume (MCV) and ferritin. Across all ethnicities, patients with VLSC were more likely to have lower haemoglobin, MCV, ferritin and vitamin D than controls with anogenital psoriasis, but only for haemoglobin and MCV was this statistically significant. It appeared that haemoglobin, MCV and vitamin D were lower in Asian patients with VLSC than in Asian controls, but this did not reach statistical significance. However, there was a statistically significant difference in haemoglobin, MCV and ferritin levels between Asian and White patients, irrespectively of diagnosis. Our data suggest that Asian patients with VLSC may be more prone to the disease than White patients, due to lower haemoglobin, MCV and ferritin. Asian women appear to be at higher risk of anaemia and vitamin D deficiency due to a combination of genetic and environmental factors, and treatment may help control of the skin. Further studies with larger sample sizes may help to ensure matched numbers of patients of different ethnicities.