VULVAR LICHEN SCLEROSUS AND SQUAMOUS CELL CARCINOMA- CARCINOGENESIS MECHANISM, RISK FACTORS AND PREVENTION STRATEGIES: A LITERATURE REVIEW

Abstract

Vulvar Lichen Sclerosus (VLS) is a chronic inflammatory dermatosis with a well-documented association with the development of vulvar Squamous Cell Carcinoma (SCC). This study aimed to synthesize recent scientific literature on the relationship between VLS and SCC, focusing on diagnostic methods, therapeutic interventions, and secondary prevention strategies. This integrative literature review was based on the mapping of 25 primary studies (E01 to E25). The rate of malignant transformation from VLS to SCC ranged from 2% to 7% in most studies, potentially reaching 15% in high-risk populations with specific genetic alterations, such as TP53 mutations and p16 dysfunction. Regarding therapeutic and preventive approaches, continuous maintenance therapy with high-potency topical corticosteroids was identified as a key intervention for tissue stabilization and prevention of second primary tumors. Additionally, emerging techniques, including molecular biomarkers, Optical Coherence Tomography (OCT), and regenerative and laser therapies, have expanded the possibilities for early diagnosis and tissue restoration. Based on these findings, continuous dermatogynecological follow-up and ensuring clear surgical margins (>8 mm) are highlighted as relevant measures for reducing morbidity, mortality, and recurrence, reinforcing the need for standardized care protocols in both primary and specialized care settings.