2020, Number 09
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Ginecol Obstet Mex 2020; 88 (09)
A lichen planus subtype papulo-squamous or classic: Vulvar and extragenital presence
Narváez-Salazar M, Gabasa-Gorgas L, Espiau-Romera A, Giménez-Molina C, de la Peña Dieste-Pérez AM, Ruiz-Campo L
Language: Spanish
References: 18
Page: 632-637
PDF size: 253.70 Kb.
ABSTRACT
Background: Vulvar lichen planus is a subtype of dermatological pathology that
is presented as erosive, papulo-erythematous, or hypertrophic lesions on the vulva.
This lesion could appear in isolation or with concomitant extragenital involvement.
Case Report: A 41-year-old patient with no previous history of interest, who attended
due to the onset of itchy skin lesions of two months of evolution. At medical examination,
multiple erythematous squamous, violaceous, hyperkeratotic papules were observed,
with Koebner phenomenon and a tendency to cluster at the forearms and wrists, dorsum
of the feet and trunk. The same lesions were seen in inguinal folds, vulvar and perianal
region. We also notice an asymptomatic non-itchy 3 mm papule with violet edge in
left labia majora (it had a whitish reticulate on the surface called Wickham's striae) and
other erosive papules 11 mm and 3 mm respectively, with violet edge. No vaginal or
other mucosal lesions were seen. Diagnosis of vulvar papule-squamous lichen planus
was established which coexists with a cutaneous hypertrophic form. Given the selflimited
nature of this pathology, a wait-and-see approach and symptomatic treatment
of pruritus with oral antihistamines was adopted. Six weeks later, disappearance of the
cutaneous lesion without cicatricial areas was observed.
Conclusions: It is essential to carry out an anamnesis and gynecological examination
in dermatological preocedures, especially when mucosas are involvement to avoid
under-diagnosis. The biopsy of the lesions will be useful when there are doubts in the
diagnosis, and it is essential in isolated hypertrophic vulvar lesions.
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