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Chapter 4 - Things That Look White

Published online by Cambridge University Press:  10 August 2023

Gayle Fischer  and
Jennifer Bradford
Gayle Fischer
Affiliation:
University of Sydney
Jennifer Bradford
Affiliation:
University of Western Sydney
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Summary

White- or pale-appearing patches on the vulva are uncommon. Most white vulval lesions are lichen sclerosus. However, vulval intra-epithelial neoplasia (VIN) may also appear white, and dermatitis complicated by lichenification or lichen simplex chronicus may also appear white.

In the past, white patches on the vulva were called ‘leukoplakia’. This term rarely appears anymore and should be regarded as out of date. It should be abandoned in favour of specific diagnostic terms. Because of the potential diagnostic confusion, white lesions on the vulva in adults should be biopsied if possible.

Type
Chapter
Information
The Vulva
A Practical Handbook for Clinicians
 , pp. 37 - 56
Publisher: Cambridge University Press
Print publication year: 2023

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References

Further Reading

Bradford, J., Fischer, G. (2010). Long-term management of vulval lichen sclerosus in adult women. Aust NZ J Obstet Gynaecol, 50, 148–52.CrossRefGoogle ScholarPubMed
Bradford, J., Fischer, G. (2013). Surgical division of labial adhesions in vulvar lichen sclerosus and lichen planus. J Lower Genital Tract Dis, 50, 48–50.Google Scholar
Chi, C. C., Kirtschig, G., Baldo, M. et al. (2011). Topical interventions for genital lichen sclerosus (Cochrane Review). Coch Libr, (12), CD008240.Google Scholar
Cooper, S. M., Ali, I., Baldo, M. et al. (2008). The association of lichen sclerosus and erosive lichen planus of the vulva with autoimmune disease. Arch Dermatol, 144, 1432–5.CrossRefGoogle ScholarPubMed
Cooper, S. M., Gao, X.-H., Powell, J. J. et al. (2004). Does treatment of vulval lichen sclerosus influence its prognosis? Arch Dermatol, 104, 702–6.Google Scholar
Dalziel, K. L., Millard, P. R., Wojnarowska, F. (1991). The treatment of vulval lichen sclerosus with a very potent topical corticosteroid (clobetasol propionate 0.05%) cream. Br J Dermatol, 124, 461–4.CrossRefGoogle Scholar
Ellis, E., Fischer, G. (2015). Prepubertal-onset vulvar lichen sclerosus: the importance of maintenance therapy in long-term outcomes. Pediatr Dermatol, 32, 461–7.Google Scholar
Hengge, U. R., Krause, W., Hofmann, H. et al. (2006). Multicentre, phase II trial on the safety and efficacy of topical tacrolimus ointment for the treatment of lichen sclerosus. British J. Dermatol, 155, 1021–8.CrossRefGoogle ScholarPubMed
Jones, R. W., Sadler, L., Grant, S. et al. (2004). Clinically identifying women with vulvar lichen sclerosus at increased risk of squamous cell carcinoma: a case control study. J Reprod Med, 49, 808–11.Google ScholarPubMed
Lee, A., Bradford, J., Fischer, G. (2015). Longterm management of vulvar lichen sclerosus. JAMA Dermatol, 151, 1061–7.Google ScholarPubMed
Powell, J., Wojnarowska, F. (2001). Childhood vulval lichen sclerosus: an increasingly common problem. J Am Acad Dermatol., 44, 803–6.CrossRefGoogle ScholarPubMed
Renaud-Vilmer, C., Cavalier-Balloy, B., Porcher, R. et al. (2004). Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. Arch Dermatol, 140, 709–12.Google Scholar
Sideri, M., Jones, R. W., Wilkinson, E. J. et al. (2005). Squamous vulvar intraepithelial neoplasia: 2004 modified terminology ISSVD Vulvar Oncology subcommittee. J Reprod Med, 50, 807–10.Google Scholar
Sinha, P., Sorinola, O., Luesley, D. (1999). Lichen sclerosus of the vulva: long term maintenance therapy. J Reprod Med, 44, 621–4.Google Scholar
Smith, S. D., Fischer, G. O. (2009). Childhood onset vulvar lichen sclerosus does not resolve at puberty: a prospective case series. Pediatr Dermatol, 26, 725–9.CrossRefGoogle Scholar
Wijaya, M., Lee, G. L., Fischer, G. (2021). Quality of life of women with untreated vulval lichen sclerosus assess vulval quality of life Index. Austral. J. Dermatol, 62, 177–82.CrossRefGoogle ScholarPubMed
Wijaya, M., Lee, G., Fischer, G, Lee, A. (2021). Quality of life of vuvlar lichen sclerosus patients treated with long-term topical corticosteroids. J Low Genit Tract Dis, 25, 158–65.CrossRefGoogle ScholarPubMed
Yeon, J., Oakley, A., Olsson, A. et al. Vulval lichen sclerosus: an Australasian Management Concensus. Aust. J. Dermatol, 62, 292–9.Google Scholar

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