Erosive vulvar lichen planus: retrospective review of characteristics and outcomes in 113 patients seen in a vulvar specialty clinic.
OBJECTIVE
To describe the characteristics of women diagnosed with erosive vulvar lichen planus and the outcome of treatment utilized by a single practitioner.


METHODS
A retrospective review of 113 women with erosive vulvar lichen planus. Data were abstracted, including demographic information, medical history, vulvar symptom scores and treatments utilized. Dyspareunia and vulvar symptom scores before and following treatment were compared.


RESULTS
The mean age at presentation for women with lichen planus was 50 years. Comorbid medical and vulvar conditions were commonly noted. Sexually active women noted an improvement in dyspareunia symptom score and report of pain-free intercourse. Other symptoms described by women at the first visit included: burning (n = 76), itching (69), pain (43) and abnormal discharge (71). While these symptoms were significantly reduced at the final visit (p < 0.05 for each), the presence of vulvovaginal symptoms commonly waxed and waned in this group. Overall, 33% had resolution of symptoms, and 19% had improvement without resolution of symptoms.


CONCLUSIONS
This cohort extends our understanding of the characteristics of women with erosive vulvar lichen planus and emphasizes its characteristically chronic course. While the recognition of erosive vulvar lichen planus may prevent unnecessary medical and surgical procedures, continued efforts to improve treatment should be investigated.
Kennedy
Colleen M
CM
Department of Obstetrics and Gynecology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City IA 52242, USA. colleen-kennedy@uiowa.edu
Galask
Rudolph P
RP
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008010:Lichen Planus / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D014845:Vulvar Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; C117268:pimecrolimus; D016559:Tacrolimus