%0 Journal Article
%T Vulval lichen planus¨Clichen sclerosus overlap
%A Anthony Hall
%A Matthew Howard
%J International Journal of STD & AIDS
%@ 1758-1052
%D 2018
%R 10.1177/0956462418758777
%X Vulval lichen planus¨Clichen sclerosus overlap is an emerging observation. Few clinical reports exist with no reviews of literature. We present a focused update of this phenomenon and discuss a clinical case. We report a 63-year-old woman with a 20-year history of ulcerative vulvo-vaginitis, initially diagnosed as benign mucous membrane (cicatricial) pemphigoid. This led to prolonged treatment with oral corticosteroids with minimal improvement in symptoms. Subsequent complications of long-term use of systemic corticosteroid ensued. A clinico-pathological diagnosis of severe erosive lichen planus was made on clinical findings and on non-specific biopsy changes of ulceration and inflammation. Treatment with topical clobetasol propionate 0.05% ointment twice daily led to dramatic improvement of ulceration, easing of discomfort and marked improvement in quality of life. Clinical examination revealed WickhamĄ¯s striae on the labia majora supporting the diagnosis. Six years after commencement of topical clobetasol, white plaques were noticed on the labia majora, perineum and peri-anal region consistent with lichen sclerosus, confirmed by repeat vulval skin biopsy and on vulvectomy. This case highlights the challenge of diagnosis of extensive vulvo-vaginal ulceration and the necessity to re-examine a previous diagnosis if there is poor response to treatment
%K Lichen planus
%K lichen sclerosus
%K vulvar ulceration
%K vulval ulceration
%K ulcerative vulvo-vaginitis
%K female genital dermatoses
%U https://journals.sagepub.com/doi/full/10.1177/0956462418758777