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Lichen planus affecting the female genitalia

Lichen planus is an inflammatory condition that causes purplish, itchy, flat-topped bumps on the skin. On mucous membranes, the condition forms lacy white patches, sometimes with painful sores. Genital or vulval lichen planus may have a disabling effect on a patient’s quality of life, and evidence-based management guidelines are lacking.

A study published in the Journal of the American Academy of Dermatology reviewed the clinical presentation and treatment of 100 patients who received a diagnosis of vulval lichen planus between January 1997 and December 2015 at Mayo Clinic, USA.

 It found that the time to diagnosis for 49 per cent of patients was more than one year. Three patients had vulval dysplasia, including invasive squamous cell carcinoma. Sixty-eight patients had multisite lichen planus disease. Eleven patients had disease remission; dermatology was the lead specialty for nine of these cases of remission.
The study surmised that a low frequency of disease remission was seen in patients with vulval lichen planus, but that patients benefit considerably from dermatology consultation. It recommended that further research is warranted to establish high-quality, evidence-based guidelines for multidisciplinary management of this challenging disease.

Lichen planus affecting the female genitalia: A retrospective review of patients at Mayo Clinic. Fahy, Caoimhe M.R. et al. Journal of the American Academy of Dermatology, Volume 77, Issue 6, 1053-1059

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