1/3. lichen planus and the vulvovaginal-gingival syndrome.lichen planus is a dermatologic disease that affects both skin and mucosa. Here we report five cases of lichen planus that presented as the oral component of the vulvovaginal-gingival syndrome. Four of the cases were associated with biopsy-proven oral lichen planus, and all five patients had oral lesions that clinically resembled lichen planus. Three patients were taking medications that are associated with lichenoid drug reactions; four patients were postmenopausal; and all five patients had desquamative vulvovaginitis. Clinicians may see these patients when they show persistent signs and symptoms of oral lichen planus. We report five case histories and review the 127 cases found in the literature to make the practicing clinician aware of this unusual clinical entity. The hepatitis c virus association and drug-induced lichenoid mucositis are topics that are addressed. In addition, clarification of the issues surrounding the premalignant potential of oral lichen planus is provided with evidence, rationale, and data from the literature to support the position that true oral lichen planus has no inherent predisposition to become malignant.- - - - - - - - - - ranking = 1keywords = vulvovaginal (Clic here for more details about this article) |
2/3. The use of acellular dermal graft for vulvovaginal reconstruction in a patient with lichen planus.BACKGROUND: Vulvovaginal lichen planus is an inflammatory dermatosis that can progress to an erosive form with scarring of the vulva, resorption of the labia minora, vaginal synechiae, and vaginal obliteration secondary to desquamative vaginitis. Traditionally, conservative medical therapy has consisted of topical corticosteroids and immunosuppressants. CASE: A 61-year-old woman with a history of refractory erosive vulvovaginal lichen planus presented with complete obliteration of the vaginal vault. The patient failed both medical and conservative surgical management and desired definitive management. After performing a skinning vulvectomy and simple vaginectomy, acellular dermal graft was used for grafting the vulva and creating a neovagina. CONCLUSION: Acellular dermal graft is a suitable graft material for vulvar and vaginal reconstruction in select patients, and it avoids the postoperative pain associated with graft harvest sites.- - - - - - - - - - ranking = 1keywords = vulvovaginal (Clic here for more details about this article) |
3/3. Severe vulvar scarring in patients with erosive lichen planus: a report of 4 cases.BACKGROUND: Oral lichen planus (LP) is thought to affect 1% of the population. It is an autoimmune inflammatory disease process with varied clinical manifestations. Glabrous skin scarring is rare, but that of mucosal membranes may be more common than recognized. It has been estimated that 25% of patients with oral lesions also harbor genital lesions. CASE: We report 4 cases of LP with genital involvement treated at various stages of development. Severe mucosal scarring occurred, and vulvovaginal scarring commonly resulted in significant dyspareunia. CONCLUSION: Early and aggressive diagnosis and therapy may abrogate the scarring potential of this debilitating disease process.- - - - - - - - - - ranking = 0.2keywords = vulvovaginal (Clic here for more details about this article) |