Vulva, vagina & female urethra
To be resorted
Vulvar dystrophy

Topic Completed: 1 December 2013

Minor changes: 14 August 2020

Copyright: 2002-2020,, Inc.

PubMed Search: "Vulvar dystrophy"

Monika Roychowdhury, M.D.
Page views in 2019: 5,148
Page views in 2020 to date: 3,640
Cite this page: Roychowdhury M. Vulvar dystrophy. website. Accessed October 20th, 2020.
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)
  • 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
  • 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
  • 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

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