Photodiagnosis Photodyn Ther 2018 Apr 15. Epub 2018 Apr 15.

University of Florence School of Health Sciences, Department of Surgical and Translational Medicine, Section of Dermatology, P. Palagi Hospital, Viale Michelangelo 41, 50125, Florence, Italy.

Photodynamic Therapy is a procedure based on the interaction between a Photo Sensitizer, a light source with a specific wavelength and oxygen. Aim of this Review is to provide a brief and updated analysis of scientific reports of the use of PDT with topical PS in the management of oncological, infectious, and inflammatory disorders involving mucosal and semimucosal areas, with a specific focus on diseases of dermatologic interest. Read More

Acta Odontol Scand 2018 Apr 16:1-10. Epub 2018 Apr 16.

c Head and Neck Center, Oral and Maxillofacial Diseases , Helsinki University Hospital , Helsinki , Finland.

Objectives: Lichen sclerosus (LS) is a rare, chronic mucocutaneous disease that most frequently affects the female genital area. Oral manifestations are seldom detected; only 36 well-documented and histopathologically verified oral LS cases have been published.

Materials And Methods: Here we describe one patient affected by oral (LS) and review of the literature 1957-2017. Read More

Clin Dermatol 2018 Mar - Apr;36(2):208-221. Epub 2017 Oct 3.

Department of Dermatology, Alpert Medical School of Brown University, Providence, RI; Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil. Electronic address:

Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. Read More

G Ital Dermatol Venereol 2018 Apr;153(2):289-291

Department of Dermatology and Venereology, University of Trieste, Trieste, Italy.

Skin Res Technol 2018 Feb 18. Epub 2018 Feb 18.

Dermatology Clinic, University of Catania, Catania, Italy.

Background: The term balanitis includes a variety of inflammatory skin diseases involving the glans penis whose clinical diagnosis may be challenging. A biopsy is often required to obtain a definitive diagnosis, although it is barely accepted by patients. Reflectance confocal microscopy (RCM), that provides a real-time, en face imaging of the epidermis and upper dermis, is currently utilized for the diagnosis of some neoplastic and inflammatory skin diseases. Read More

J Pediatr Surg 2018 Jan 3. Epub 2018 Jan 3.

Department of Surgery, Alder Hey Children's Hospital, Liverpool, UK; University of Liverpool, Liverpool, United Kingdom. Electronic address:

Purpose: To determine whether treatment of lichen sclerosus et atrophicus (LS), with topical steroids reduces the rate of circumcision.

Methods: Two independent reviewers performed a literature search of studies reporting treatment of LS with topical steroids using EMBASE and MEDLINE database(s).

Inclusion Criteria: boys aged 0-18 years, clinical diagnosis of LS, treatment with topical steroids. Read More

Gene 2018 May 12;653:43-50. Epub 2018 Jan 12.

Department of Gynecology and Obstetrics, The First Affiliated Hospital of China Medical University, Liaoning 110001, China. Electronic address:

Vulvar lichen sclerosis (VLS) is a chronic inflammatory skin disorder. Evidence is accumulating that microRNAs (miRNAs) exert crucial roles in initiation and development of a wide range of human diseases. MiR-155-5p has been frequently reported to be implicated in the tumorigenesis and progression of multiple types of cancers, however, its biological role in VLS remains unclear. Read More

J Dermatol 2017 Dec 19. Epub 2017 Dec 19.

Department of Molecular Pathology of Skin, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.

We established diagnostic criteria and severity classification of lichen sclerosus et atrophicus, because there is no established diagnostic criteria or widely accepted severity classification of the disease. Also, there is no clinical guideline for lichen sclerosus et atrophicus in Japan, so we proposed its clinical guideline. The clinical guidelines were formulated by clinical questions and recommendations on the basis of evidence-based medicine according to the New Minds Clinical Practice Guideline Creation Manual (version 1. Read More

Photodiagnosis Photodyn Ther 2018 Mar 16;21:234-238. Epub 2017 Dec 16.

Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China. Electronic address:

Background: Vulvar lichen sclerosus et atrophicus (VLSA) is a chronic inflammatory skin disease of unknown etiology that mainly affects postmenopausal and perimenopausal women. The primary clinical symptoms of VLSA are itching, burning pain, and dyspareunia that can results in decreased quality of life. Existing therapies including topical corticosteroid ointment, topical calcineurin inhibitors, estrogens, are not very effective for treatment of VLSA. Read More

Int J Womens Dermatol 2017 Dec 20;3(4):225-227. Epub 2017 Aug 20.

Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH.

Lichen planus pemphigoides (LPP) is a rare blistering disease with features of both lichen planus and bullous pemphigoid. LPP typically appears on the extremities and occasionally involves the oral mucosa. Herein, we describe a case of LPP of the vulva of an 80-year-old woman, an uncommon location for this disease process. Read More

Actas Dermosifiliogr 2018 Jan - Feb;109(1):86-88. Epub 2017 Oct 10.

Servicio de Anatomía Patológica, Hospital Universitario Central de Asturias, Oviedo, España.

Open Access Maced J Med Sci 2017 Aug 10;5(5):692-693. Epub 2017 Aug 10.

Medical Institute of Ministry of Interior (MVR), Department of Dermatology and Dermatologic Surgery, Generel Skobelev 79, 1606 Sofia, Bulgaria.

We present a 74-year-old male patient with 3-years history of visible discoloration of the glans penis, without subjective complaints. Histopathological examination after incision biopsy revealed a moderate increase in the number of melanocytes in the basal layer with irregular distribution, without melanocytic nests, melanophages in the superficial dermis, and subepidermal sclerosus. No cytologic atypia of melanocytes was detectable. Read More

Oral Surg Oral Med Oral Pathol Oral Radiol 2017 Oct 3;124(4):e243-e248. Epub 2017 Aug 3.

University of Alabama at Birmingham, Birmingham, AL, USA; University of Central Florida, Orlando, FL, USA. Electronic address:

Objective: The aim of this study was to evaluate the disease involvement, treatment and response, and malignant potential of oral lichen sclerosus (LS).

Study Design: We conducted a review of the literature of 37 cases of oral LS. We looked specifically for the following data: patient demographic characteristics, disease involvement, treatment, response to treatment, duration of follow-up, symptoms, risk factors for oral malignancy, and malignant transformation. Read More

Urologe A 2017 Oct;56(10):1266-1273

Klinik für Plastische und Ästhetische Chirurgie - Handchirurgie - Wiederherstellungschirurgie, St. Antonius-Hospital Eschweiler, Aachen, Deutschland.

The adult buried penis afflicts the patient with shame and is also potentially associated with considerable urogenital complications. Due to obesity, chronic urogenital lymphedema or subsequent inflammatory urogenital conditions, such as a lichen sclerosus et atrophicus, the clinical appearance of the adult buried penis is extremely variable. Epidemiological data are non-existent. Read More

J Midlife Health 2017 Apr-Jun;8(2):55-62

Department of Dermatology and Venereology, Pramukshwami Medical College, Karamsad, Gujarat, India.

Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia, dysuria, and urinary or fecal incontinence. Anogenital lichen sclerosus (LS) is characterized by porcelain-white atrophic plaques, which may become confluent extending around the vulval and perianal skin in a figure of eight configuration. Read More

Climacteric 2017 Aug 29;20(4):339-347. Epub 2017 Jun 29.

b Lower Genital Tract Disease Unit , Centro Hospitalar de São João , Porto , Portugal.

Female lichen sclerosus is a chronic inflammatory dermatitis, with a predilection for the anogenital area, which in some cases can become seriously distorted (atrophy of the labia minora, phimosis, introital stenosis, etc.). Most cases are diagnosed in postmenopausal women, but it can affect women of any age. Read More

Dermatol Online J 2017 Jun 15;23(6). Epub 2017 Jun 15.

Michigan State University Dermatology Residency Program, Beaumont Hospital Farmington Hills, Farmington Hills, Michigan.

Lichen sclerosus (LS) is a benign, chronic, inflammatory skin disease with a predilection for the anogenital region in women. Although males can also be affected, the ratio of female to male incidence has been reported to be as high as 6-10:1 and possesses a bimodal age distribution of pre-pubertal girls and postmenopausal women [1, 2]. Affected skin usually demonstrates polygonal papules that coalesce into porcelain white plaques and can be associated with edema, telangiectasias, and comedo-like plug formation [3]. Read More

Dermatol Online J 2017 06 15;23(6). Epub 2017 Jun 15.

Department of Dermatology, Hospital Santa Casa de Curitiba, Curitiba, Paraná, Brazil.

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory dermatosis, characterized by shiny, atrophic, hypochromic papules with a predilection for the genital and perineal skin. Extragenital involvement may occur, but is rare in the isolated form. LSA more commonly affects prepubertal and postmenopausal women. Read More

JAMA Dermatol 2017 Oct;153(10):1067-1069

Division of Dermatology, Washington University School of Medicine, St Louis, Missouri.

J Pediatr Adolesc Gynecol 2017 Dec 15;30(6):646-648. Epub 2017 May 15.

Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada; Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Ontario, Canada.

Background: We describe an unusual presentation of lichen sclerosus in a postmenarchal, virginal girl.

Case: A 14-year-old girl first presented with acute urinary retention due to labial agglutination and developed bilateral tubo-ovarian abscesses in 10 days of the conservative management period. Abscesses were treated with antibiotherapy and percutaneous drainage; simple division of the labial agglutination and vulvar biopsies were performed with a preliminary diagnosis of lichen sclerosus. Read More

Klin Padiatr 2017 Jul 2;229(4):247-248. Epub 2017 May 2.

Klinik für Hautkrankheiten, Universitatsklinikum Jena, Jena.

Dermatol Clin 2017 Apr;35(2):135-144

Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9069, USA. Electronic address:

Vitiligo has a variety of presentations, including focal, acrofacial, segmental, and generalized forms. Thorough knowledge of these presentations is important to make the correct diagnosis. Signs of activity are important to recognize so that treatment is optimized. Read More

Dermatol Clin 2017 Apr;35(2):117-128

Department of Dermatology, EpiDermE, Henri Mondor Hospital, Université Paris-Est Créteil Val-de-Marne, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.

Vitiligo is a complex, systemic disease associated with many autoimmune and autoinflammatory conditions. Additionally, the cutaneous changes of vitiligo have significant effects on quality of life and self-esteem. Further efforts are needed to increase our understanding of vitiligo comorbidities as well as to increase awareness of the psychological effects of vitiligo. Read More

An Bras Dermatol 2016 Sep-Oct;91(5 suppl 1):81-83

Clinical Center of Serbia, Faculty of Medicine, University of Belgrade - Belgrade, Serbia.

Lichen sclerosus et atrophicus is a chronic disease of unknown etiology characterized by atrophic and sclerotic plaques in both genital and extragenital regions. Extensive bullous lichen sclerosus et atrophicus (BLSA) is a severe variant of the disease with no widely accepted treatment. We present a 63-year-old woman with extensive extragenital, ivory-colored, atrophic plaques on her trunk and extremities and disseminated hemorrhagic bullae. Read More

Pan Afr Med J 2016 24;25:190. Epub 2016 Nov 24.

Service de Dermatologie, CHU Ibn Sina Rabat, Maroc.

Lichen sclerosus et atrophicus is a chronic inflammatory dermatosis, characterized by a specific external genital mucosal tissue tropism. Isolated cutaneous manifestation is rare. We report a case of lichen sclerosus et atrophicus in a woman with purely cutaneous involvement, in order to highlight the importance of evoking this diagnosis in the absence of obvious genital involvement. Read More

J Urol 2017 Aug 10;198(2):401-406. Epub 2017 Mar 10.

Department of Urology, Shanghai Jiaotong University Affiliated Sixth People's Hospital and Shanghai Eastern Urological Reconstruction and Repair Institute (YMX, HX, YLS, QF, JZ, CF, CRJ, LJS, HBL), Shanghai, China; Department of Urology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.

Purpose: We evaluated outcomes and donor site complications in male patients with complex urethral strictures who underwent urethroplasty using with long strip oral mucosal grafts. We also analyzed whether a lingual mucosa graft is a good substitute for repairing long segment urethral strictures.

Materials And Methods: This retrospective study was done in 81 male patients with complex urethral strictures who underwent oral mucosal graft urethroplasty. Read More

Br J Dermatol 2017 Feb;176(2):307-316

St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, U.K.

Lichen sclerosus is one of the dermatoses that specifically affects the anogenital skin. It has peaks of incidence in prepubertal girls and postmenopausal women. The objective of this critical appraisal was to review systematically the evidence for efficacy and safety of different treatments. Read More

Int J Dermatol 2017 May 27;56(5):589-591. Epub 2017 Feb 27.

Center of Aesthetic Medicine, Department of Dermatology, Medical University Graz, Graz, Austria.

Background: The use of special silk textiles (Dermasilk) has shown positive effects on chronic inflammatory diseases like lichen sclerosus et atrophicus, atopic dermatitis, diabetic ulcerations, and vulvovaginal candidiasis.

Objective: Wearing T-shirts of this particular fabric could be useful in the management of patients with acne vulgaris on the back and trunk.

Material And Methods: Dermasilk T-shirts were given to 14 patients with acne vulgaris papulopustulosa on the back. Read More

Photodiagnosis Photodyn Ther 2017 Jun 17;18:128-132. Epub 2017 Feb 17.

School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Batorego 15, 41-902, Bytom, Poland. Electronic address:

Background: Lichen sclerosus (LS) is a difficult to treat, often relapsing disease with unknown background. Autoimmune diseases also coexist with LS. Over recent years photodynamic therapy (PDT) has been shown to be a noninvasive and successful therapeutic approach for the effective treatment of many conditions. Read More

Indian Dermatol Online J 2017 Jan-Feb;8(1):57-59

Department of Dermatology, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.

Int J STD AIDS 2017 09 16;28(10):1048-1050. Epub 2017 Feb 16.

Department of Dermatology, St John's Medical College, Bangalore, India.

Vulvovaginal lichen planus is a type of chronic inflammatory dermatosis of the vulva, usually seen as a part of widespread lichen planus. The common clinical types of vulval lichen planus include papulosquamous, erosive and pigmented types. Hypertrophic lichen planus of the vulva is a rare entity. Read More

Int Urol Nephrol 2017 Apr 4;49(4):573-580. Epub 2017 Feb 4.

Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Via De Toni 16, 16132, Genoa, Italy.

Purpose: Lichen sclerosus (LS) is a chronic inflammatory skin condition that frequently involves the anogenital region. Ongoing research is focused on finding more effective treatments for tissue repair and reducing symptoms. The aim of this study is to evaluate the effectiveness of platelet-rich plasma (PRP) local injections in penile LS. Read More

Int J Cancer 2017 05 10;140(9):1998-2002. Epub 2017 Feb 10.

Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.

Malignant potential of lichen sclerosus (LS) has been suspected, but evidence is sparse. We used the population-based Finnish Cancer Registry data to further study this connection. We identified all women with the diagnosis of LS (n = 7,616) listed in the Finnish Hospital Discharge Registry from 1970 to 2012. Read More

J Pediatr Urol 2017 04 9;13(2):210-211. Epub 2016 Dec 9.

Department of General Surgery, Alder Hey Children's Hospital, Eaton Road, Liverpool, L12 2AP, UK. Electronic address:

J Am Acad Dermatol 2017 Feb;76(2S1):S49-S51

Institute of Dermatology, Catholic University, Rome, Italy. Electronic address:

Int J STD AIDS 2017 08 12;28(9):940-942. Epub 2017 Jan 12.

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Several factors such as genetic susceptibility, autoimmunity, hormones, infections, local trauma, urine, and occlusion have been speculated to play a role in the pathogenesis of lichen sclerosus. We report two male patients with lichen sclerosus around 'ectopic' urethral openings and the opposing surfaces of the penile shaft and scrotum, providing further evidence in support of urine and occlusion as contributing factors in the development of lichen sclerosus. Read More

J Pediatr Urol 2017 Apr 9;13(2):208.e1-208.e4. Epub 2016 Dec 9.

Alder Hey Children's NHS Foundation Trust, Department of Paediatric Surgery, E Prescot Rd, Liverpool, L14 5AB, UK.

Introduction: Over 27,000 circumcisions were performed in England in 2012-13. The complication rate is generally perceived to be low, although published figures vary widely. Balanitis xerotica obliterans, more correctly termed Lichen Sclerosus et atrophicus (LS), is one of the commonest indications for medical circumcision. Read More

J Pediatr Urol 2017 04 5;13(2):209. Epub 2016 Dec 5.

Department of Urology, Ghent University Hospital, Belgium. Electronic address:

G Ital Dermatol Venereol 2017 02;152(1):92-94

Infectious Dermatology and Allergology Unit (STI/HIV Unit), San Gallicano Dermatologic Institute, IRCCS, Rome, Italy -

G Ital Dermatol Venereol 2017 02;152(1):83-84

Department of Dermatology, Umberto I Polyclinic, Sapienza University, Rome, Italy.

J Cosmet Laser Ther 2017 Apr 2;19(2):106-108. Epub 2017 Feb 2.

a Dermatology Department , Clínica Dermitek , Bilbao , Spain.

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory disease of unknown cause that typically affects the genital area (1). It has been reported in post-traumatic areas as a result of Koebner phenomenon. LSA responds poorly to treatment making it a therapeutic challenge (2). Read More

Urol Clin North Am 2017 Feb;44(1):77-86

Division of Urology, Department of Surgery, Duke University Medical Center, DUMC 3146, Durham, NC 27710, USA.

Lichen sclerosis (LS) is a chronic, relapsing disease with a variable presentation. In men, genitourinary LS may affect the penile foreskin, glans, meatus, and urethra. Treatment is multifaceted, ranging from pharmacotherapy to surgery. Read More

J Eur Acad Dermatol Venereol 2017 May 28;31(5):876-879. Epub 2016 Nov 28.

Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

Background: Obesity is increasing. Male genital lichen sclerosus (MGLSc) is almost exclusively a disease of the uncircumcised. An apparent increasing challenge is MGLSc in previously circumcised obese males. Read More

Int J Cancer 2017 Mar;140(5):1134-1146

MRC-University of Glasgow Centre for Virus Research, University of Glasgow.

It is universally accepted that high-risk human papillomavirus (HR-HPV) is the cause of cervical dysplasia and cancer. More recently, it has been shown that HPV is also a marker of clinical outcome in oropharyngeal cancer. However, contemporary information is lacking on both the prevalence of HPV infection in vulvar cancer (VSCC), its precursor lesion, vulvar intraepithelial neoplasia (VIN) and the influence of HPV-status on the prognosis of this malignancy. Read More

Clin Exp Dermatol 2017 Jan 13;42(1):61-63. Epub 2016 Nov 13.

Department of Medicine and Aging Science, Dermatologic Clinic, University G. d'Annunzio, Chieti, Italy.

Polyglandular autoimmune syndrome (PAS) is the name given to a group of autoimmune disorders of the endocrine glands. PAS type III (PAS III) comprises several autoimmune diseases (autoimmune thyroiditis, immune-mediated diabetes mellitus, pernicious anaemia, vitiligo, alopecia areata and many others) and is subdivided into four subcategories. We report the case of a 52-year-old woman with autoimmune thyroiditis, vitiligo, alopecia areata, psoriasis and lichen sclerosus, suggesting a clinical diagnosis of PAS IIIC with a singular prevalence of cutaneous features. Read More

Rom J Morphol Embryol 2016 ;57(2 Suppl):817-823

Department of Ophthalmology, "Grigore T. Popa" University of Medicine and Pharmacy, Iassy, Romania;

Lichen sclerosus et atrophicus and limited systemic scleroderma (acrosclerosis) are inflammatory skin diseases that ultimately evolve into two distinct modes of atrophic scar formation, but which can easily be confused clinically. They are very rarely associated. The literature has reported cases in which lichen sclerosus was associated with various forms of scleroderma, but often with localized morphea. Read More

Actas Urol Esp 2017 Mar 3;41(2):123-131. Epub 2016 Nov 3.

Departamento de Urología, Universidad de Lisboa, Hospital de Santa María, Lisboa, Portugal.

Introduction: Panurethral stricture associated with lichen sclerosus is a therapeutic challenge. We present the analysis of our results using two urethroplasty techniques based on oral mucosa graft.

Material And Method: Retrospective study in patients with long anterior urethral stricture (>8cm) associated with lichen sclerosus. Read More

Head Neck Pathol 2017 Jun 2;11(2):212-218. Epub 2016 Nov 2.

Oral Pathology Division, School of Dentistry, Pontifical Catholic University of Minas Gerais, Avenida Dom José Gaspar, 500, Prédio 46, Sala 101, Coração Eucarístico, Belo Horizonte, MG, 30535-901, Brazil.

Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disease that often affects the anogenital area and causes significant discomfort and morbidity. Oral mucosal lesions in LS are extremely rare and might be associated with genital and/or skin manifestations. As a unique manifestation of LS, oral lesions are even more rare, with only 20 cases reported in English-language literature. Read More

Pathologe 2016 Nov;37(6):526-533

Institut für Pathologie, Abteilung Mamma-, Gynäko- und Perinatalpathologie, Universitätsklinikum Leipzig AöR, Liebigstraße 26, 04103, Leipzig, Deutschland.

The majority of precancerous lesions of the lower female genital tract (intraepithelial neoplasia, IN) are caused by human papillomavirus (HPV) infections resulting in cellular atypia and in turn an altered tissue architecture. Depending on the pathogenesis, a distinction is made between vulvar intraepithelial neoplasia (VIN) classified as classical VIN associated with high-risk HPV infections (u-VIN) and differentiated VIN (d-VIN), which is associated with lichen sclerosus et atrophicus and p53 alterations. In the current World Health Organization (WHO) classification a novel grading system for squamous cell precancerous lesions of the lower female genital tract has been proposed, differentiating low grade squamous intraepithelial lesions (L-SIL) including condyloma and HPV-associated alterations plus VIN 1, vaginal intraepithelial neoplasia (VaIN 1) and cervical intraepithelial neoplasia (CIN 1) from high grade squamous intraepithelial lesions (H-SIL) with VIN 2 and 3, VaIN 2 and 3 as well as CIN 2 and 3. Read More

Br J Dermatol 2017 Jun 21;176(6):1508-1515. Epub 2017 Mar 21.

Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Background: Although they are considered relevant, little is known about satisfaction with treatment and health-related quality of life (HRQoL) among patients with lichen sclerosus (LS).

Objectives: In a cross-sectional study, we aimed to examine (i) satisfaction with treatment, (ii) patient characteristics associated with satisfaction and (iii) HRQoL in Dutch patients with LS.

Methods: Members of the Dutch LS Patient Association (n = 750) were invited to complete a web-based survey. Read More