M. Rotaru, G. Iancu, T. Constantin, M. M. Constantin
Abstract: Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition classified as precancerous dermatosis of the genital mucosa, associated with a risk of progression to in situ, then invasive vulvar squamous cell carcinomas. Although the etiology of this disease has not been determined, the factors involved in its pathogenesis are genetic, autoimmune, hormonal, infectious as well as environmentally-mediated. Given the risk of malign progression, these type of skin lesions have to be carefully watched by regular clinical exams, and a biopsy of the affected genital mucosa should be carried out whenever dysplasia or malign transformation is suspected. Vulvar carcinogenesis is a multistage process, regardless of the type (i.e. differentiated or not) of intraepithelial vulval neoplasia (IVN), which includes human papilloma viruses (HPV)-negative immune-mediated inflammatory disease, mainly the VLS. The involvement of HPV as main trigger in IVN has been clearly confirmed. The present paper comprises a synthetic review of the available literature on this borderline type of disease referred to as VLS, and looks at the mainly clinical and diagnostic aspects that need to be observed by the clinicians. Considering the potential for progression of the disease, it is of foremost importance to diagnose VLS in an early stage, to closely follow up with the gynecologist and dermatologist, while carefully and steadily monitoring these lesions and to initiate the appropriate disease-specific treatment.
DOI:10.18643/gieu.2015.70
Keywords: vulvar lichen sclerosus, vulvar carcinoma, precancerous lesions, early diagnosis.