Vulva
Nonneoplastic disorders
Vulvar dystrophy

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 4 October 2017, last major update December 2013

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: "Vulvar dystrophy"

Cite this page: Roychowdhury, M. Vulvar dystrophy. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/vulvavulvardystrophy.html. Accessed November 20th, 2017.
Definition / general
  • Unrelated disorders of epithelial growth that present as irregular patchy areas of thickened skin and severe itching
  • Types:
    • Squamous cell hyperplasia (most common form)
    • Lichen sclerosus
    • Other dermatoses (e.g. psoriasis and lichen planus, skin changes secondary to chronic infections)
  • Often white skin (leukoplakia) but may be red
  • Easily traumatized
  • Suggested to diagnose as dermatosis, not as vulvar dystrophy (Mod Pathol 1997;10:401)
Etiology
  • Many inciting factors, including skin infections and skin irritants
  • However, once established, patients natural itch scratch cycle can perpetuate the problem
Clinical features
  • Grey or white patches
  • Vulvar skin becomes too thick or too thin
  • Frequently extreme burning or itching
Diagnosis
  • Clinical examination
  • Further classified based on biopsy findings
Prognostic factors
  • Most lesions have no premalignant potential but if dysplasia is present, can be associated with a low risk for squamous cell carcinoma
Treatment
  • Corticosteroid cream
Clinical images

Images hosted on other servers:

White epithelium with atrophic labia majora

Microscopic (histologic) description
  • Lichen sclerosus
    • Epidermal and dermal atrophy
    • Thinning of epithelium with blunting / loss of rete pegs
    • Superficial dermal chronic inflammation
    • In late stages, there is band like hyalinization of dermal collagen
  • Squamous hyperplasia
    • Epithelial thickening with acanthosis, hyperkeratosis or parakeratosis
    • Nuclear atypia not seen
Microscopic (histologic) images

Images hosted on other servers:

Mild hyperkeratosis

Epithelial thickening

Chronic inflammatory cell infiltrate

Squamous hyperplasia