Mucosal vulval lichen planus: outcome, clinical and laboratory features.
BACKGROUND
Mucosal lichen planus of the vulva is a rare but increasingly recognized condition. It has potentially severe complications such as fusion of the labia and vagina; the risk of developing squamous cell carcinoma (SCC) may be increased. An association between hepatitis B and C infection and skin or oral lichen planus appears to exist in certain geographical areas.


OBJECTIVE
To investigate the course of mucosal vulval lichen planus, its response to treatment and associated laboratory features.


METHODS
Forty-four women with mucosal vulval lichen planus were studied between 1997 and 2000 and laboratory data were collected.


RESULTS
Thirty of 44 patients had additional oral lesions, only nine had cutaneous findings compatible with lichen planus. We did not find an association with antibodies to hepatitis B or C virus in this British study population. All women were treated with potent to very potent topical corticosteroids; however, in the majority of patients symptoms persisted. In seven (16%) patients vulval lichen planus was in remission after a disease duration between 2 and 18 years (mean 10.6 years). One patient developed a vulval SCC.


CONCLUSIONS
Screening for hepatitis B and C in women with mucosal vulval lichen planus in the UK seems unnecessary. We recommend long-term follow-up, and that all non-healing ulcerative and papular lesions should be biopsied.
Kirtschig
G
G
Department of Dermatology, University Hospital Vrije Universiteit, De Boelelaan 1117, Amsterdam, the Netherlands. g.kirtschig@vumc.nl
Wakelin
S H
SH
Wojnarowska
F
F
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000209:etiology; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008010:Lichen Planus / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D017676:Lichen Planus, Oral / Q000150:complications; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome; D014845:Vulvar Diseases / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000209:etiology
D000305:Adrenal Cortex Hormones; D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies