Department of Obstetrics and Gynecology II, Pisa University Hospital , Pisa , Italy.
Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa , Pisa , Italy.
Gynecol Endocrinol. 2019 Nov;35(11):938-940. doi: 10.1080/09513590.2019.1617265. Epub 2019 May 26.
Lichen planus (LP) is a chronic immune-mediated dermatosis mainly affecting skin, oral, and genital mucosa. The heterogeneous clinical presentation, spectrum of symptoms depending on subtype and overlap with other vulval and cutaneous disorders can lead to challenging in diagnosis. We report an unusual case of vulval SCC arising within a patient with initial oral mucosal lichen planus who later developed lichen planus of the vulva. Discussion of this case is important as it typifies the difficulties in diagnosis of vulvo-vaginal disorders and potential complications. Evidence is available that lichen planus may be potentially precancerous condition and is associated with SCC development. This case may confirm an inherent oncologic potential of the disease. All efforts must be made by specialists involved in the management of this disease to obtain an early diagnosis, ensure proper treatment and adequate follow up. This highlights the need to perform vulval examination in patients with symptoms or with a history muco-cutaneous LP and if necessary consider referral to specialist center for biopsy and management.
扁平苔藓(LP)是一种主要影响皮肤、口腔和生殖器黏膜的慢性免疫介导性皮肤病。不同的临床表现、根据亚型的症状谱以及与其他外阴和皮肤疾病的重叠,可能导致诊断具有挑战性。我们报告了一例罕见的外阴 SCC 病例,该患者最初患有口腔黏膜扁平苔藓,后来发展为外阴扁平苔藓。讨论这个病例很重要,因为它典型地说明了外阴阴道疾病的诊断困难和潜在的并发症。有证据表明,扁平苔藓可能是一种潜在的癌前病变,与 SCC 的发展有关。这个病例可能证实了该疾病的内在肿瘤发生潜能。参与这种疾病治疗的专家必须尽一切努力进行早期诊断,确保适当的治疗和充分的随访。这突出表明,对于有症状或有黏膜皮肤 LP 病史的患者,需要进行外阴检查,如果必要,应考虑转介至专门的中心进行活检和管理。