Vulvar Lichen Sclerosus
Lichen Sclerosus et Atrophicus
Vulvodynia
Lichens
Lichen Planus
Clobetasol
Vulva
Phimosis
Scleroderma, Localized
Lichen Planus, Oral
A clinico-pathological study of vulval dermatoses. (1/15)
A long-term review of 108 women suffering from various forms of vulval dermatosis is described and a detailed analysis of those with chronic hypertrophic vulvitis, lichen sclerosus et atrophicus, and neurodermatitis is made. One case of neurodermatitis and two cases of lichen sclerosus progressed to carcinoma but no case of chronic hypertrophic vulvitis became malignant. It is possible that vulval dermatoses occur more commonly in the nulliparous than in the parous women and there is a slight preponderance of women who are blood group A. It is suggested that the term "leukoplakia" should be abandoned and that vulval lesions should be described in precise and meaningful histological terms. (+info)Mucinous metaplasia of the vulva in a case of lichen sclerosus. A case report. (2/15)
Mucinous metaplasia of the genital area is a rare condition characterised by the emergence of mucin containing cells in stratified squamous epithelium. This report describes a unique case of benign mucinous metaplasia of the vulva associated with lichen sclerosus in a 60 year old woman. Histopathology revealed cervical type metaplasia with otherwise typical lichen sclerosus. This report discusses the pathogenesis and differential diagnosis of mucinous epithelium. (+info)The association between HLA DR, DQ antigens, and vulval lichen sclerosus in the UK: HLA DRB112 and its associated DRB112/DQB10301/04/09/010 haplotype confers susceptibility to vulval lichen sclerosus, and HLA DRB10301/04 and its associated DRB10301/04/DQB10201/02/03 haplotype protects from vulval lichen sclerosus. (3/15)
Lichen sclerosus (LS) is considered to have an immunogenetic background. Several small studies, using serological typing, have reported that HLA-DR11, DR12, and DQ7 were increased in LS, with DR17 less frequent. This study aimed to validate and detect new HLA-DR and DQ associations with LS in females and its characteristic clinical parameters. The cases, 187 female LS patients, and 354 healthy controls were all UK North Europeans. PCR-sequence specific primers method was applied to genotype the HLA-DR, DQ polymorphisms that correspond to 17 serologically defined DR and seven DQ antigens. Statistical analysis was performed with two-tailed Fisher's exact test with Bonferroni adjustment (p value after Bonferrroni adjustment, Pc). We found increased frequency of DRB1*12 (DR12) (11.2%vs 2.5%, pc < 0.01) and the haplotype DRB1*12/DQB1*0301/04/09/010 (11.2%vs 2.5%, p < 0.001, pc < 0.05), and a lower frequency of DRB1*0301/04 (DR17) (11.8%vs 25.8%, pc < 0.01) and the haplotype DRB1*03/DQB1*02DRB1*0301/DQB1*0201/02/03 (11.2%vs 24.6%, pc < 0.0001) in patients compared with controls. HLA DR and DQ antigens were not associated with time of onset of disease, site of involvement, structural changes of genitals, and response to treatment with potent topical steroids. In conclusion, HLA-DR and DQ antigens or their haplotypes appear to be involved in both susceptibility to and protection from LS. (+info)In the absence of (early) invasive carcinoma, vulvar intraepithelial neoplasia associated with lichen sclerosus is mainly of undifferentiated type: new insights in histology and aetiology. (4/15)
BACKGROUND: Differentiated vulvar intraepithelial neoplasia (VIN) is presumed to be the precursor of invasive squamous cell carcinoma (SCC) of the vulva. It is commonly assumed that differentiated VIN is related to lichen sclerosus (LS). However, evidence for this is limited to a small number of studies describing epithelial alterations adjacent to vulvar SCC. AIM: To study the histology and human papillomavirus (HPV) status in patients with a history of both LS and VIN without coexistent SCC. METHODS: Original biopsy specimens and surgical specimens of patients retrieved from the pathology files were revised for the presence of LS, VIN and (early) invasive SCC, specifically focused on the two different types of VIN: differentiated and undifferentiated. Thereafter, VIN lesions were tested for the presence of HPV DNA. RESULTS: Twenty-seven patients fulfilled the criteria for LS and VIN without SCC. In all 27 patients, LS was found to be related to undifferentiated VIN. Grading yielded the following results: VIN 1 (n=10), VIN 2 (n=11) and VIN 3 (n=6). Additionally, VIN lesions from 26 patients could be tested for the presence of HPV DNA. HPV DNA, predominantly type 16, was present in 8 (31%) of them. Seven of these eight patients had VIN 2 or 3. During follow-up, three patients progressed to (early) invasive carcinoma. In two of these patients, differentiated VIN was observed overlying early invasive SCC. CONCLUSIONS: VIN related to LS without coexisting SCC is likely to be undifferentiated, in contrast to what was previously thought. HPV DNA was demonstrated in 31% of the lesions, and was strongly related to high-grade VIN. (+info)Unexpectedly high frequency of genital involvement in women with clinical and histological features of oral lichen planus. (5/15)
The main aims of this cross-sectional study were: (i) to assess the frequency of genital (vulval) lichen planus (VLP) and vulval lichen sclerosus (VLS) in women affected with oral lichen planus (OLP), regardless of the genital symptoms reported; and (ii) to verify whether any demographic, clinical, or histological features of OLP are associated with a higher risk of vulvo-vaginal involvement. Fifty-five women, presenting OLP, consecutively underwent gynaecological examination and, if they demonstrated positive clinical signs of VLP, underwent biopsy. After a drop-out of 14 subjects, 31/41 (75.6%) were found to have signs of genital involvement, of which 13/31 (44.0%) were asymptomatic. Following genital biopsy, 27/31 (87.1%) had histologically confirmed VLP or VLS. Following both univariate and multivariate statistical analyses, no significant association was found between gynaecological concomitance and demographic, clinical, histological features of OLP. This unpredictably common genital involvement in females with OLP emphasizes the importance of routinely performing both oral and gynaecological examinations, to facilitate an early and correct therapeutic approach. (+info)Vulvar lichen sclerosus: 11 women treated with tacrolimus 0.1% ointment. (6/15)
Lichen sclerosus is a chronic relapsing disease, usually treated with ultra-potent corticosteroids. As immunological alterations are considered important aetiopathogenetic factors in lichen sclerosus, the new immunomodulating topical agents, such as tacrolimus and pimecrolimus, have been employed sporadically as alternative therapies. The aim of this study was to evaluate the therapeutic effects of tacrolimus 0.1% ointment in lichen sclerosus in 11 patients unresponsive or poorly responsive to previous treatments. Tacrolimus 0.1% ointment was applied twice daily for 6 weeks, then tapered over a further 6 weeks. Symptoms and objective parameters were evaluated and quantified at the start, after 6 weeks, at the end of the topical treatment, and at follow-up visits. Improvement or remission of symptoms was observed in the patients who completed the study, while objective parameters were poorly influenced and often were not related to symptom behaviour. Topical tacrolimus can be considered an alternative treatment for lichen sclerosus. (+info)Single base instability is promoted in vulvar lichen sclerosus. (7/15)
Single base substitution mutations in codons 248 and 273 of TP53 and codon 12 Kirsten-ras (KRAS) are commonly found in human carcinomas. To determine whether these mutations also occur in normal and inflamed tissues from which carcinomas arise, we utilized the ultra-sensitive polymerase chain reaction/restriction endonuclease/ligase chain reaction mutation assay. Ninety samples of genital skin, including lichen sclerosus (LS) affected skin, adjacent normal and non-adjacent normal, were assayed. Mutations were detected in 103 of 349 assays and consisted of KRAS G34A, G34T, G35A, and TP53 C742T, G818C, C817T, and G818A mutations. Mutant prevalence varied from 1 to 20 per 10(6) wild-type cells. Mutations occurred significantly more frequently in LS (78/224 (35%)) than adjacent normal (20/88 (23%)) and non-adjacent normal genital skin (5/38 (13%)). KRAS G34A mutation was relatively common to all classes of specimen, whereas TP53 gene C742T and G818C mutations were significantly more frequent in LS than normal genital skin. In matched samples, immunohistochemistry evaluation of p53 protein expression revealed the presence of epidermal p53 clones in LS whose presence and number significantly correlated with the presence of TP53 C742T and G818C mutations. Based on these results, it appears oncogenic point mutations occur in normal genital skin, and are selected for in LS. (+info)Non-neoplastic epithelial disorders of the vulva. (8/15)
Lichen sclerosus, lichen planus, and lichen simplex chronicus are three of the most common non-neoplastic epithelial disorders of the vulva. Lichen sclerosus is characterized by intense vulvar itching and can affect men and women of all ages, but it manifests most commonly in postmenopausal women. Patients with lichen sclerosus have an increased risk of developing squamous cell carcinoma, and they should be monitored for malignancy. Lichen planus is an inflammatory autoimmune disorder that can affect the vulva and the vagina; it peaks in incidence between ages 30 and 60. There are three clinical variants of lichen planus affecting the vulva: erosive, papulosquamous, and hypertrophic. Lichen simplex chronicus is caused by persistent itching and scratching of the vulvar skin, which results in a thickened, leathery appearance. It is thought to be an atopic disorder in many cases and may arise in normal skin as a result of psychological stress or environmental factors. Definitive diagnosis of non-neoplastic disorders depends on the histology of biopsied tissue. All three disorders are treated with topical corticosteroid ointments of varying potency. Lichen sclerosus and lichen planus are not routinely treated with surgery, which is necessary only in patients who have a malignancy or advanced scarring that causes dyspareunia or clitoral phimosis. Educational counseling teaches patients that even though these chronic disorders cannot be cured, they can be effectively managed. (+info)Vulvar Lichen Sclerosus (VLS) is a chronic inflammatory skin condition that affects the genital skin, particularly the vulva in women. It is characterized by thin, white, crinkly skin that can be patchy or involve the entire vulvar area. The skin may become fragile and tear easily, leading to pain, itching (pruritus), discomfort, and soreness. In some cases, VLS can cause scarring and narrowing of the vaginal opening, which can make sexual intercourse painful.
The exact cause of Vulvar Lichen Sclerosus is not known, but it may be associated with hormonal imbalances, genetics, or an autoimmune response. While there is no cure for VLS, various treatments can help manage the symptoms and prevent complications. Topical corticosteroids are often used to reduce inflammation and relieve itching. Regular follow-ups with a healthcare provider are essential to monitor the condition and adjust treatment as necessary.
Lichen Sclerosus et Atrophicus (LSEA) is a chronic inflammatory skin condition that can affect both males and females, but it's most commonly found in women after menopause. It can occur at any age, including children. The condition typically affects the genital and anal areas, though it can appear elsewhere on the body as well.
The medical definition of Lichen Sclerosus et Atrophicus is:
A skin disorder characterized by white patches (plaques) that can be smooth or wrinkled, thickened, and easily bruised. These patches may merge to form larger areas of affected skin. The condition can cause itching, burning, pain, and blistering. In women, the vulva is often affected, and sexual intercourse may become painful. In men, it can affect the foreskin and glans penis, leading to difficulty urinating or having sex.
The exact cause of Lichen Sclerosus et Atrophicus remains unknown, but it's believed that hormonal imbalances, genetics, and an overactive immune system may play a role in its development. Treatment usually involves topical corticosteroids to reduce inflammation and alleviate symptoms. In some cases, other medications or phototherapy might be recommended. It is essential to consult with a healthcare professional for proper diagnosis and treatment.
Vulvodynia is a chronic pain condition that affects the vulva, which is the external female genital area. The main symptom is persistent, often burning or irritating pain without an identifiable cause. Some women may experience pain only when the area is touched (provoked vulvodynia), while others have constant pain (unprovoked vulvodynia).
The pain can significantly affect a woman's quality of life, making everyday activities like sitting, wearing tight clothes, or having sex uncomfortable or even unbearable. The exact cause of vulvodynia is not known, but it may be associated with nerve damage or irritation, hormonal changes, muscle spasms, allergies, or past genital infections. Treatment often involves a multidisciplinary approach and can include medication, physical therapy, lifestyle changes, and counseling.
Lichens are not a medical term, but I can provide a biological definition for you. Lichens are unique symbiotic organisms that result from the mutualistic relationship between fungi (usually Ascomycetes) and photosynthetic partners, such as algae or cyanobacteria. The fungal partner provides protection and anchorage, while the photosynthetic partner supplies carbohydrates through photosynthesis. Lichens are widely distributed and can be found growing on various substrates, including rocks, trees, and soil. They play essential ecological roles, such as soil stabilization, atmospheric nitrogen fixation, and biomonitoring of air pollution.
Vulvar diseases refer to a range of medical conditions that affect the vulva, which is the external female genital area including the mons pubis, labia majora and minora, clitoris, and the vaginal opening. These conditions can cause various symptoms such as itching, burning, pain, soreness, irritation, or abnormal growths or lesions. Some common vulvar diseases include:
1. Vulvitis: inflammation of the vulva that can be caused by infection, allergies, or irritants.
2. Lichen sclerosus: a chronic skin condition that causes thin, white patches on the vulva.
3. Lichen planus: an inflammatory condition that affects the skin and mucous membranes, including the vulva.
4. Vulvar cancer: a rare type of cancer that develops in the tissues of the vulva.
5. Genital warts: caused by human papillomavirus (HPV) infection, these are small growths or bumps on the vulva.
6. Pudendal neuralgia: a nerve condition that causes pain in the vulvar area.
7. Vestibulodynia: pain or discomfort in the vestibule, the area surrounding the vaginal opening.
It is important to consult a healthcare professional if experiencing any symptoms related to vulvar diseases for proper diagnosis and treatment.
Lichen Planus is a chronic, autoimmune skin condition that can also affect the mucous membranes inside the mouth, genitals, and eyes. It is characterized by the appearance of purplish, flat-topped bumps or lesions on the skin, which may be itchy. The exact cause of Lichen Planus is unknown, but it is believed to occur when the immune system mistakenly attacks cells in the skin or mucous membranes. Certain medications, viral infections, and genetic factors may increase the risk of developing this condition. Treatment typically focuses on managing symptoms and may include topical corticosteroids, oral medications, or light therapy.
Vulvar neoplasms refer to abnormal growths or tumors in the vulvar region, which is the exterior female genital area including the mons pubis, labia majora, labia minora, clitoris, and the vaginal vestibule. These neoplasms can be benign (non-cancerous) or malignant (cancerous).
Benign vulvar neoplasms may include conditions such as vulvar cysts, fibromas, lipomas, or condylomas (genital warts). They are typically slow-growing and less likely to spread or invade surrounding tissues.
Malignant vulvar neoplasms, on the other hand, are cancers that can invade nearby tissues and potentially metastasize (spread) to distant parts of the body. The most common types of malignant vulvar neoplasms are squamous cell carcinoma, vulvar melanoma, and adenocarcinoma.
Early detection and treatment of vulvar neoplasms are essential for improving prognosis and reducing the risk of complications or recurrence. Regular gynecological examinations, self-examinations, and prompt attention to any unusual symptoms or changes in the vulvar area can help ensure timely diagnosis and management.
Clobetasol is a topical corticosteroid medication that is used to reduce inflammation and relieve itching, redness, and swelling associated with various skin conditions. It works by suppressing the immune system's response to reduce inflammation. Clobetasol is available in several forms, including creams, ointments, emulsions, and foams, and is usually applied to the affected area once or twice a day.
It is important to use clobetasol only as directed by a healthcare provider, as prolonged or excessive use can lead to thinning of the skin, increased susceptibility to infections, and other side effects. Additionally, it should not be used on large areas of the body or for extended periods without medical supervision.
The vulva refers to the external female genital area. It includes the mons pubis (the pad of fatty tissue covered with skin and hair that's located on the front part of the pelvis), labia majora (the outer folds of skin that surround and protect the vaginal opening), labia minora (the inner folds of skin that surround the vaginal and urethral openings), clitoris (a small, sensitive organ located at the front of the vulva where the labia minora join), the external openings of the urethra (the tube that carries urine from the bladder out of the body) and vagina (the passageway leading to the cervix, which is the lower part of the uterus).
It's important to note that understanding the anatomy and terminology related to one's own body can help facilitate effective communication with healthcare providers, promote self-awareness, and support overall health and well-being.
Phimosis is a medical condition where the foreskin of the penis, which is the retractable sheath of skin that covers the head or glans of the penis, cannot be pulled back (retracted) over the glans. This condition is normal in uncircumcised infant boys and toddlers, but most boys can retract their foreskins by the time they reach puberty.
In some cases, phimosis may cause no symptoms or problems, while in others it may lead to issues such as discomfort, pain, especially during sexual activity, infection, inflammation, and difficulty urinating. Phimosis can be caused by various factors, including infections, skin conditions, scarring from previous injuries or surgeries, or forceful attempts to retract the foreskin.
Treatment for phimosis depends on the underlying cause and severity of the condition. In some cases, gentle manual stretching exercises may be recommended to gradually increase the foreskin's ability to retract. In other cases, topical creams or medications may be prescribed to reduce inflammation or fight infections. If these treatments are not effective, or if phimosis is causing significant discomfort or complications, circumcision (surgical removal of the foreskin) may be considered as a last resort.
Penile diseases refer to a range of medical conditions that affect the penis, including infections, inflammatory conditions, and structural abnormalities. Some common penile diseases include:
1. Balanitis: an infection or inflammation of the foreskin and/or head of the penis.
2. Balanoposthitis: an infection or inflammation of both the foreskin and the head of the penis.
3. Phimosis: a condition in which the foreskin is too tight to be pulled back over the head of the penis.
4. Paraphimosis: a medical emergency in which the foreskin becomes trapped behind the head of the penis and cannot be returned to its normal position.
5. Peyronie's disease: a condition characterized by the development of scar tissue inside the penis, leading to curvature during erections.
6. Erectile dysfunction: the inability to achieve or maintain an erection sufficient for sexual intercourse.
7. Penile cancer: a rare form of cancer that affects the skin and tissues of the penis.
These conditions can have various causes, including bacterial or fungal infections, sexually transmitted infections (STIs), skin conditions, trauma, or underlying medical conditions. Treatment for penile diseases varies depending on the specific condition and its severity, but may include medications, surgery, or lifestyle changes.
Localized scleroderma, also known as morphea, is a rare autoimmune disorder that affects the skin and connective tissues. It is characterized by thickening and hardening (sclerosis) of the skin in patches or bands, usually on the trunk, limbs, or face. Unlike systemic scleroderma, localized scleroderma does not affect internal organs, although it can cause significant disfigurement and disability in some cases.
There are two main types of localized scleroderma: plaque morphea and generalized morphea. Plaque morphea typically presents as oval or circular patches of thickened, hard skin that are often white or pale in the center and surrounded by a purple or darker border. Generalized morphea, on the other hand, is characterized by larger areas of sclerosis that can cover much of the body surface.
The exact cause of localized scleroderma is not fully understood, but it is thought to involve an overactive immune system response that leads to inflammation and scarring of the skin and underlying tissues. Treatment typically involves a combination of topical therapies (such as corticosteroids or calcineurin inhibitors), phototherapy, and systemic medications (such as methotrexate or mycophenolate mofetil) in more severe cases.
Lichen Planus, Oral is a relatively common inflammatory condition that affects the mucous membranes inside the mouth. It is characterized by the presence of white, lacy patches (called Wickham's striae), papules, or plaques on the oral mucosa, which can be uncomfortable or painful, especially when eating spicy, salty, or acidic foods. The condition can also cause soreness, redness, and ulceration in some cases.
The exact cause of oral lichen planus is not known, but it is believed to be related to an abnormal immune response in which the body's immune system attacks the cells in the oral mucosa. The condition can affect people of any age, but it is most commonly seen in middle-aged adults, and it affects women more often than men.
While there is no cure for oral lichen planus, treatment can help to manage symptoms and prevent complications. Topical corticosteroids are often used to reduce inflammation and relieve pain, while systemic medications may be prescribed in severe cases. It is important to avoid irritants such as tobacco, alcohol, and spicy foods, which can exacerbate symptoms. Regular dental check-ups are also recommended to monitor the condition and prevent any complications.
Lichen sclerosus