Vulval lichen planus

Lichen planus is an uncommon skin disorder which can affect any part of the skin. In some patients it clears spontaneously after months or a year or two. In others it is more persistent.

Vulval lichen planus of the erosive type is a painful condition which can interfere with sexual intercourse. Often there is superficial ulceration of the entrance to the vagina and the surrounding vulva skin. The changes can also extend into the vagina. Scarring can result in reduction of the labia minora (inner lips of the vulva) and partial closure of the entrance to the vagina.

Sometimes vulval lichen planus shows white streaks and small lumps more typical of lichen planus that occurs elsewhere on the skin.

Patients with vulval lichen planus often have similar changes in the mouth affecting the gums, inside the cheeks and the tongue.

Lichen planus is usually diagnosed by taking a small biopsy (cutting out a small piece of skin from an affected area)

Treatment of vulval lichen planus is usually initiated with steroid creams or ointments. If these are not effective enough on their own, two newer medications pimecrolimus or tacrolimus, both available as creams or ointments might be used as well. Sometimes systemic oral medications may be necessary. If the vagina is affected, a cortisone foam can be inserted.

Lichen planus can be a very persistent condition. It is uncommon and can be difficult to treat. Your doctor should refer you to a dermatologist for ongoing management.

For more information go to DermNet NZ.