Other studies evidenced an inflammatory response in genital LS; the expression of several pro-inflammatory cytokines, such as IFN-γ, TNF-α, IL-1α and IFN-γ receptor, was increased in specimens of vulval lichen sclerosus from adult women compared with specimens of normal vulva and normal skin [6,31]. This evidence concerns the gene TNF and lichen sclerosus et atrophicus.