Vulval lichen planus-lichen sclerosus overlap

International Journal of STD & AIDS
Matthew Howard, Anthony Hall

Abstract

Vulval lichen planus-lichen sclerosus overlap is an emerging observation. Few clinical reports exist with no reviews of literature. We present a focused update of this phenomenon and discuss a clinical case. We report a 63-year-old woman with a 20-year history of ulcerative vulvo-vaginitis, initially diagnosed as benign mucous membrane (cicatricial) pemphigoid. This led to prolonged treatment with oral corticosteroids with minimal improvement in symptoms. Subsequent complications of long-term use of systemic corticosteroid ensued. A clinico-pathological diagnosis of severe erosive lichen planus was made on clinical findings and on non-specific biopsy changes of ulceration and inflammation. Treatment with topical clobetasol propionate 0.05% ointment twice daily led to dramatic improvement of ulceration, easing of discomfort and marked improvement in quality of life. Clinical examination revealed Wickham's striae on the labia majora supporting the diagnosis. Six years after commencement of topical clobetasol, white plaques were noticed on the labia majora, perineum and peri-anal region consistent with lichen sclerosus, confirmed by repeat vulval skin biopsy and on vulvectomy. This case highlights the challenge of diagnosis of ext...Continue Reading

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Citations

May 28, 2019·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Stefano BasilePierluigi Benedetti Panici
Nov 21, 2020·Journal of Lower Genital Tract Disease·Joana LyraPedro Vieira-Baptista

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Methods Mentioned

BETA
biopsy
biopsies

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