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Clinicopathologic Diagnostic Criteria for Vulvar Lichen Planus.

Clinicopathologic Diagnostic Criteria for Vulvar Lichen Planus.

Authors :
Day T
Wilkinson E
Rowan D
Scurry J
Source :
Journal of lower genital tract disease [J Low Genit Tract Dis] 2020 Jul; Vol. 24 (3), pp. 317-329.
Publication Year :
2020

Abstract

Objective: The aim of the study was to describe the clinical and histopathologic features required for a clinicopathologic diagnosis of vulvar lichen planus (LP), which is divided into 3 types: erosive, classic, and hypertrophic.<br />Materials and Methods: The International Society of the Study of Vulvovaginal Diseases tasked the Difficult Pathologic Diagnoses committee with development of a consensus document for the clinicopathologic diagnosis of vulvar LP, lichen sclerosus, and differentiated vulvar intraepithelial neoplasia. The LP subgroup reviewed the literature and formulated diagnostic criteria, then approved by the International Society of the Study of Vulvovaginal Diseases membership.<br />Results: The clinicopathologic diagnosis of erosive LP incorporates 5 criteria: (a) a well-demarcated, glazed red macule or patch at labia minora, vestibule, and/or vagina, (b) disease affects hairless skin, mucocutaneous junction, and/or nonkeratinized squamous epithelium, (c) evidence of basal layer damage, categorized as degenerative or regenerative, (d) a closely applied band-like lymphocytic infiltrate, and (e) absent subepithelial sclerosis. The clinicopathologic diagnoses of classic and hypertrophic LP each require a characteristic clinical appearance accompanied by hyperkeratosis, hypergranulosis, acanthosis, basal layer degeneration, a closely applied lymphocytic infiltrate, and absent dermal sclerosis, with hypertrophic LP showing marked epithelial abnormality compared with classic LP.<br />Conclusions: Clinicopathological correlation yields the most reliable diagnosis of vulvar LP. Disease appearance overlaps with other physiologic, dermatologic, infectious, and neoplastic entities; a low threshold for biopsy at all morphologically distinct areas is recommended. Use of the histopathologic criteria described in this document may reduce the nondiagnostic biopsy rate for clinically diagnosed LP.

Details

Language :
English
ISSN :
1526-0976
Volume :
24
Issue :
3
Database :
MEDLINE
Journal :
Journal of lower genital tract disease
Publication Type :
Academic Journal
Accession number :
32205763
Full Text :
https://doi.org/10.1097/LGT.0000000000000532