Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc
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Review

Volume 14, Number 4, December 2025, pages 113-121

Microbiome Dysbiosis in Lichen Sclerosus: A Systematic Review

Figure

Figure 1.
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram. Adapted from Ref [13].

Tables

Table 1. Inclusion and Exclusion Criteria
 
Study characteristicsInclusion criteriaExclusion criteria
PopulationFemale patients with lichen sclerosus diagnosed clinically or via biopsy of any ageAnimals, males
ContextVulvar skin and/or vaginal microbiome composition in the setting of lichen sclerosusGeneral population only (not involving patients with lichen sclerosus)
Study designRetrospective chart reviews, cohort studies, case-control studies, case series, cross-sectional studiesCase reports, review articles, editorials, protocols, animal studies, studies with < 5 participants
PublicationAfter 2000; accessible in EnglishBefore 2000; not accessible in English

 

Table 2. Differences in Vulvar Skin Microbiome of Patients With and Without Lichen Sclerosus
 
StudyAlpha diversityMicrobes of interest
Alpha diversity metrics are described as higher, lower, or no difference by comparing vulvar lichen sclerosus patients to controls. Taxa are described to be in higher (H) or lower (L) relative abundance or no difference (N) when comparing patients with lichen sclerosus to patients without lichen sclerosus. *Not statistically significant. All other values have a P-value < 0.05.
Chattopadhyay et al (2021) [15]No difference (Shannon)Firmicutes* (L)
Prevotella (H)
Peptoniphilus (H)
Campylobacter (H)
Porphyromonas (H)
Clostridium (H)
Enterobacter cloacae (H)
Prevotella melaninogenica (H)
Liu et al (2022) [10]Lower (ACE, Chao1)
No difference (Shannon, Pielou)		Firmicutes (L)
Gammaproteobacteria (H)
Clostridia (H)
Lactobacillales (L), Lactobacillaceae (L)
Atopobiaceae (L), Atopobium (L)
Enterobacteriaceae (H)
Prevotella (N)
Lactobacillus (L)
Peptoniphilus (H)
Porphyromonas (H)
Campylobacter (H), Campylobacter ureolyticus (H)
Lactobacillus jensenii (H)
Lactobacillus iners (L)
Ma et al (2024) [11]No difference (ACE, Chao1, Obs richness)Prevotella (L)
Campylobacter ureolyticus (H)
Pagan et al (2023) [9]Lower (Shannon)
No difference (Chao1)		Papillomaviridae (H)
Prevotella (L)
Alphapapillomavirus (H)
Pyle et al (2024) [16]Lower (4/4)Firmicutes (L - perineum)
Lactobacillus (L - clitoris)
Atopobium (L - clitoris)
Candida (H - labia minora), Candida glabrata (L - all)
Lactobacillus jensenii (L - perineum)

 

Table 3. Differences in Vaginal Microbiome of Patients With and Without Lichen Sclerosus
 
StudyAlpha diversityMicrobes of interest
Alpha diversity metrics are described as higher, lower, or no difference by comparing vulvar lichen sclerosus patients to controls. Taxa are described to be in higher (H) or lower (L) relative abundance or no difference (N) when comparing patients with lichen sclerosus to patients without lichen sclerosus. *Not statistically significant. All other values have a P-value < 0.05.
Brunner et al (2021) [17]No difference (Simpson, Chao1, Shannon)Streptococcus (N)
Lactobacillus (N)
Lactobacillus iners (H)
Streptococcus anginosus (N)
Ma et al (2024) [11]Lower (ACE, Chao1, Obs richness)Fusobacteriota (L), Fusobacteriia (L)
Bifidobacteriaceae (H)
Prevotellaceae (L)
Streptococcus (N)
Lactobacillus (N)
Lactobacillus crispatus (H)
Lactobacillus acidophilus (H)
Bifidobacterium bifidum (H)
Prevotella sp. (L)
Nygaard et al (2023) [18]No difference (ASV, Shannon, Pielou)Streptococcaceae (H - Lower vagina)
Bifidobacterium (H - Lower vagina)
Streptococcus (H - Lower vagina)
Lactobacillus (N)
Pyle et al (2024) [16]No difference (Shannon)Saccharomyces (H)
Candida (H)

 

Table 4. Differences in Gut Microbiome of Patients With and Without Lichen Sclerosus
 
StudyAlpha diversityMicrobes of interest
Alpha diversity metrics are described as higher, lower, or no difference by comparing vulvar lichen sclerosus patients to controls. Taxa are described to be in higher (H) or lower (L) relative abundance or no difference (N) when comparing patients with lichen sclerosus to patients without lichen sclerosus. *Not statistically significant. All other values have a P-value < 0.05.
Ma et al (2024) [11]HigherGammaproteobacteria (H)
Rikenellaceae* (H)
Bacteroidaceae*, Bacteroides* (L)
Coriobacteriales bacterium DNF00809 (H)
Chattopadhyay et al (2021) [15]HigherFirmicutes (L)
Proteobacteria (H)
Clostridiales (H)
Rikenellaceae (H)
Nygaard et al (2023) [18]No differenceEuryarchaeota (H)
Coriobacteriia, Coriobacteriales (H)
Bacteroidaceae, Bacteroides (L)