Vulval lichen sclerosus and lichen planus
Article first published online: 24 SEP 2010
© 2010 Wiley Periodicals, Inc.
Volume 23, Issue 5, pages 523–532, September/October 2010
How to Cite
McPherson, T. and Cooper, S. (2010), Vulval lichen sclerosus and lichen planus. Dermatologic Therapy, 23: 523–532. doi: 10.1111/j.1529-8019.2010.01355.x
- Issue published online: 24 SEP 2010
- Article first published online: 24 SEP 2010
- lichen sclerosus;
- lichen planus;
- mucosal lichen planus;
Lichen sclerosus (LS) and lichen planus (LP) are both immunologically mediated diseases with a preference for the genitalia. The basic principles of management of vulval LS and vulvovaginal LP are the same and involve explanation of the disease, emphasizing the chronic nature of the condition and outlining treatment options. The main difference between the two conditions is that LP has a propensity to involve the mucous membranes including the mouth and vagina which are rarely affected in LS. First-line treatment for LS is a super-potent topical corticosteroid ointment which has a high response rate. Erosive vulvovaginal LP is more challenging to treat. Second-line therapies include topical calcineurin inhibitors and systemic agents. There is limited evidence for systemic treatments for both conditions. The risk of vulval squamous cell carcinoma (SCC) is increased in both LP and LS, and it is not known how treatment affects this risk. We recommend teaching self-examination and longitudinal evaluation.