Which women with genital lichen planus will require immunosuppression?

Dermatologists say they've identified key risk factors for second-line systemic therapy

Patients with vulvovaginal lichen planus most likely to need systemic immunosuppression include those younger than 60, non-Caucasians and presenting with vulval pruritus, Australian clinicians say.

Their chart review of dozens of diagnosed cases suggest the confluence of these three risk factors can predict the need for systemic treatment with a specificity of 95%.

Given that up to 40% of women with vulvovaginal lichen planus (VLP) fail to respond to first-line topical corticosteroids — and