Korean J Dermatol.  2020 Dec;58(10):643-649.

A Clinical and Histopathological Study of 25 Cases of Vulvar Lichen Sclerosus et Atrophicus

• Kwon CI
• Kim DC
• Kim CY

Abstract

Background
Lichen sclerosus et atrophicus is an uncommon, benign, chronic lymphocyte-mediated inflammatory dermatosis that occurs mainly in the genital area. It causes substantial discomfort and morbidity, mostly in adult women.
Objective
To investigate the clinicopathological characteristics of patients with vulvar lichen sclerosus et atrophicus.
Methods
We retrospectively reviewed the clinical and histopathological features of 25 patients diagnosed with vulvar lichen sclerosus et atrophicus, who visited the dermatologic department between January 2009 and June 2017.
Results
The average age was 54.2 years, and the disease duration was mostly less than 1 year. The major clinical features were diffuse patch, followed by diffuse plaque and multiple macules. It often presented with diabetes mellitus, thyroid disease, and hypertension. Itching was the most common symptom, followed by pain and burning sensations. Histopathological findings were hyperkeratosis with follicular plugging; atrophy and loss of rete ridge elongation in the epidermis; liquefaction degeneration and keratinocyte necrosis in the dermo-epidermal junction; collagen fibers hyalinization; and infiltration of inflammatory cells in the dermis. Antihistamines and topical steroids were used in most cases for treatment.
Conclusion
Vulvar lichen sclerosus et atrophicus causes discomfort and diminishes the quality of life in older women. Early diagnosis and prompt treatment are vital in preventing disease progression and complications. This study will provide valuable data on vulvar lichen sclerosus et atrophicus to dermatologists.

Keyword

Lichen sclerosus et atrophicus; Vulvar lichen sclerosus