H.S. Cheng1, C. Kerckhoffs2, N. Perkins3, L. Eva4
Signiﬁcant health inequality persists in New Zealand despite universally funded healthcare. Anecdotally, we have observed few Maori and Paciﬁc women presenting with lichen sclerosus. The aim of this study was to docu- ment the demographics of women with lichen sclerosus seen at specialist vulval clinics.
We performed a retrospective review of women with lichen sclerosus seen at a tertiary combined gynaecology/derma- tology vulval clinic over 12 months and Sexual Health vul- val clinics over ﬁve years. Data were collected for age, ethnicity, skin biopsy, treatment, referral source and time from symptom onset to specialist diagnosis. Ethnicity was compared with Census data for the Auckland region.
335 women were included; 273 from the gynaecology/der- matology clinic and 62 from sexual health. The mean age was 60 years (standard deviation 17.8, range 8 to 95). There was very strong evidence that women seen in sex- ual health clinics were younger with a mean age differ- ence of 18 years (95% conﬁdence interval 14 to 23, p < 0.0001). The most common ethnicity was European (82%) followed by Asian (10%), Maori (4%) and Paciﬁc Peoples (3%). Compared with Census data, European women were over-represented and Maori, Paciﬁc and Asian women were under-represented. We found inequitable ethnic representation of vulval lichen sclerosus seen at our institution. Causes may include sociocultural beliefs, variations in access to care or ethnic differences in the prevalence of lichen sclerosus. Further study is required to explore the prevalence of lichen sclerosus in Asian, Maori and Paciﬁc women and potential cultural barriers to care for these women.