Vulvar Lichen Planus Research Articles

Vulval lichen planus.

Lichen planus of the vulva can occur as part of more widespread disease or in isolation. Its cause is unknown, but it can become chronic and has a potential for malignant change. It may present a difficult management problem and several treatments have been used with variable success. This review focuses on the problem of vulval lichen planus, and highlights some of the treatments and management strategies that have been used to date.

Lichen planus presenting as pruritus vulvae

A 53-year-old Caucasian woman presented with a 12month history of vulval discomfort. This began as intense pruritus and the symptoms continued to become worse. She then complained of severe pain necessitating regular oral analgesia. Attempted sexual intercourse was painful and resulted in apareunia. The patient had consulted her general practitioner on several occasions and topical oestrogens or antifungal, with mild steroids (e.g. daktacort), creams were prescribed. There had been no response to repeated courses of these preparations. On referral, examination revealed an acute erosive lower vaginitis. There was extensive scarring and the introitus was stenosed and the vagina shortened. Systemic enquiry confirmed that the patient had been diagnosed as having oral lichen planus earlier that same year. The patient was admitted for vulval biopsy under general anaesthesia, due to the severity of her symptoms and clinical findings. Histology supported the diagnosis of vulval lichen planus (Figs 1 & 2). Her postoperative course was complicated by acute urinary retention secondary to the formation of labial adhesions. These were manually freed and the patient was commenced on oral prednisolone 30 mg/day and topical clobetasol propionate (Dermovate). She improved considerably over the course of 3 days and was discharged home on oral steroids and topical clobetasol. Her condition continued to improve and after 8 weeks of oral steroids she was weaned off this medication. The topical clobetasol propionate was changed to the tess potent steroid betamethasone valerate (Betnovate). Her disease continues to be in remission.

Topical cyclosporine in the treatment of oral and vulvar erosive lichen planus: a blood level monitoring study

Topical cyclosporine in the treatment of oral and vulvar erosive lichen planus: a blood level monitoring study

A Vaginal Prosthetic Device as an Aid in Treating Ulcerative Lichen Planus of the Mucous Membrane

REPORT OF A CASE A 36-year-old woman presented with an 11-year history of chronic, painful biopsy-proven oral, vaginal, and vulvar erosive lichen planus (LP) complicated by vaginal stenosis and labial adhesions. She reported no remissions despite therapeutic trials of high-potency topical, oral, and intralesional steroids, isotretinoin, etretinate, and griseofulvin. Surgical procedures to release the labia and repeated vaginal dilatations were only temporarily successful. Pain, bleeding, and decreased vaginal orifice size prohibited sexual intercourse for 1 year. Her mother has suffered from biopsy-proven oral, vaginal, and vulvar erosive LP for 20 years. The patient's sister, brother, and grandmother also suffer from persistent oral ulcerative disease. Intense erythema of the attached upper and lower facial and lingual gingiva was present. Irregular 2- to 3-cm erosions on the buccal mucosa were present with white reticulated plaques noted on the left lower side. Pelvic examination revealed a narrow vaginal orifice. The mucosal lining of

Vulvar Lichen Planus

The clinical presentation of lichen planus of the vulva spans a spectrum from subtle, fine, reticulate papules to severe erosive disease accompanied by scarring and loss of the normal vulvar architecture. The end result may mimic other diseases. Because cutaneous lichen planus is usually absent and oral disease may be asymptomatic, the diagnosis can be easily missed unless the clinician has a high index of suspicion. Although treatment for vulvar lichen planus is suboptimal, a correct diagnosis may end the patient's search for an answer and help to prevent unnecessary procedures and therapies.