Erosive vulvar lichen planus and risk of vulvar neoplasia: retrospective
case series review
Abstract
Objective: To assess the risk of vulvar cancer and precursors in a
cohort of women with vulvar lichen planus (LP) and the clinical and
therapeutic features of these patients. Design: retrospective case
series review Setting: Lower genital tract Unit of a tertiary hospital
in Porto, Portugal Participants: 127 women with the diagnosis of vulvar
LP, followed in one institution during a period of eleven years -
January 2008 until December 2018. Main outcome measures: Demographic and
clinical data were evaluated, as well as treatment, follow-up and
histology results. Results: A total of 127 women were diagnosed with
vulvar LP. The mean follow-up time was 3.90.5 years (range 1-11 years).
Ultra-potent topical corticosteroids were first line treatment in 91.8%
(n=112), with 32 cases (25.2%) needing an alternative treatment. An
overall of 30 biopsies were performed, in 19 women (15%). Vulvar HSIL
was diagnosed in 3 (2.4%) women, 2 (1.6%) of which were later
diagnosed with vulvar squamous cell carcinoma. No cases of
differentiated vulvar intraepithelial neoplasia were observed.
Conclusion: Pre-malignant/malignant transformation in women with vulvar
LP under surveillance and compliant with treatment is low. A close
follow-up appears to be crucial to prevent future malignancy. Biopsies
should be performed whenever a suspicious lesion appears during the
follow-up.