Erosive Vulvar Lichen Planus and Risk of Vulvar Neoplasia

Lyra, Joana; Melo, Cláudia; Figueiredo, Rita; Polonia-Valente, Rita; Falcão, Vera; Beires, Jorge; Vieira‐Baptista, Pedro

doi:10.1097/lgt.0000000000000581

Cited by 9 publications

(7 citation statements)

References 28 publications

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“…In another study, the diagnosis of VC was preceded by that of dVIN (9/10 cases) and HSIL (1/10 cases) 34 . In yet another publication, the 2 cases of VC that developed during follow-up were preceded by vulvar HSIL 37 . The development of dVIN or VC was systematically associated with severe treatment-resistant disease in one study (2 cases of VC and 1 case of dVIN) 10 …”

Section: Resultsmentioning

confidence: 95%

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Risk of Development of Vulvar Cancer in Women With Lichen Sclerosus or Lichen Planus: A Systematic Review

Vieira‐Baptista

Pérez‐López

López‐Baena

et al. 2022

J Low Genit Tract Dis

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Objective: Vulvar lichen sclerosus (VLS) and possibly vulvar lichen planus (VLP) are associated with an increased vulvar cancer (VC) risk. We analyzed the risk of VC and its precursors after a diagnosis of VLS or VLP. Materials and Methods:A search was performed to identify articles describing the development of vulvar neoplasia in women with VLS or VLP. This systematic review was registered with the PROSPERO database.Results: Fourteen studies on VLS included 14,030 women without a history of vulvar neoplasia. Vulvar cancer, differentiated vulvar intraepithelial neoplasia (dVIN), and vulvar high-grade squamous intraepithelial lesion occurred in 2.2% (314/14,030), 1.2% (50/4,175), and 0.4% (2/460), respectively. Considering women with previous or current VC, the rate was 4.0% (580/14,372). In one study, dVIN preceded VC in 52.0% of the cases. Progression of dVIN to VC was 18.1% (2/11). The risk was significantly higher in the first 1-3 years after a biopsy of VLS and with advancing age; it significantly decreased with ultrapotent topical steroid use. For the 14,268 women with VLP (8 studies), the rates of VC, dVIN, and vulvar high-grade squamous intraepithelial lesion were 0.3% (38/ 14,268), 2.5% (17/689), and 1.4% (10/711), respectively.Conclusions: Vulvar lichen sclerosus is associated with an increased risk of VC, especially in the presence of dVIN and with advancing age. Ultrapotent topical steroids seem to reduce this risk. An increased risk of developing VC has been suggested for VLP. Hence, treatment and regular life-long follow-up should be offered to women with VLS or VLP.

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Section: Resultsmentioning

confidence: 95%

“…Of the 416 studies initially selected (231 after the exclusion of duplicates), 22 were considered for the analytic synthesis: 14 on VLS 1,15,16,20–30 and 8 on VLP 10,31–37 (see Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Risk of Development of Vulvar Cancer in Women With Lichen Sclerosus or Lichen Planus: A Systematic Review

Vieira‐Baptista

Pérez‐López

López‐Baena

et al. 2022

J Low Genit Tract Dis

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“…Lichen sclerosis, lichen planus, and Paget disease of the vulva were associated with vulvar cancer. [35][36][37][38][39][40] These conditions are not thought to involve HPV infection, as is differentiated vulvar intraepithelial neoplasia (VIN), which is associated with incident cancer and progression to vulvar cancer over many years. 41,42 Several studies found that the risk of associated vulvar cancer persisted beyond 5 years after a diagnosis of lichen sclerosis.…”

Section: Other Vulvar Diseasesmentioning

confidence: 99%

Executive Summary of the Lower Anogenital Tract Cancer Evidence Review Conference

Chelmow

Cejtin

Conageski

et al. 2023

Obstetrics &Amp; Gynecology

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The Centers for Disease Control and Prevention sponsored a project conducted by the American College of Obstetricians and Gynecologists to develop educational materials for clinicians on the prevention and early diagnosis of gynecologic cancers. For this final module, focusing on the cancers of the lower anogenital tract (vulva, vagina, and anus), a panel of experts in evidence assessment from the Society for Academic Specialists in General Obstetrics and Gynecology, ASCCP, and the Society of Gynecologic Oncology reviewed relevant literature and current guidelines. Panel members conducted structured literature reviews, which were then reviewed by other panel members. Representatives from stakeholder professional and patient advocacy organizations met virtually in September 2022 to review and provide comment. This article is the executive summary of the review. It covers prevention, early diagnosis, and special considerations of lower anogenital tract cancer. Knowledge gaps are summarized to provide guidance for future research.

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“…Yeon et al (4) treated 32 patients with the 2 types of lichen-like lesions of the vulva with a pelvic abdominal dynamic therapeutic apparatus, and reported a total effective rate of 93.8% and a cure rate of 18.8%. Lyra et al (5) treated 50 patients with vulvar lichen-like lesions with a pelvic abdominal dynamic therapeutic apparatus and reported a symptom improvement rate of 100%, and an effective rate of 54%. However, the effectiveness evaluation indicators of these studies were not comprehensive or perfect, and no stratified study has been conducted.…”

Section: Introductionmentioning

confidence: 99%

Comparison of electrophysiology therapy and glucocorticoid therapy in the treatment of 2 subtypes of vulvar epithelial non-neoplastic lesions: a prospective cohort study

Wei¹,

Li²,

Zhang³

et al. 2023

Ann Transl Med

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Background: Lichen-like lesions with degeneration and pigmentation alterations can be divided into the following 2 types: (I) chronic simple lichen; and (II) sclerosing lichen. The etiology of the disease is unknown. This study sought to examine the therapeutic effects of electrophysiological smooth-muscle electrical stimulation in the treatment of lichen-like lesions of the vulva.Methods: A total of 80 outpatients, who had been confirmed to have vulvar lichen-like lesions by vulvar biopsy at our hospital from November 2016 to March 2018, were prospectively included in this study. The patients received electrophysiology or glucocorticoid therapy. After completing a treatment cycle according to the clinical treatment routine, the outpatients were monitored at 1-, 3-and 6-month intervals. Patients used an improvement scale (i.e., the patient global impression of change scale) to score their subjective perceptions and subjective symptoms. The clinical curative effect scale was used to calculate the curative effect index and grade the curative effect.Results: After 1 month of treatment, the active enhancement of simple lichen in the electrophysiological treatment group and glucocorticoid treatment group improved, while the active enhancement of simple lichen in the electrophysiological treatment group improved after 3 months of treatment. After 6 months of treatment, the subjective improvement score of the electrophysiological treatment group was better than that of lichen sclerosus. After 3 months of treatment, the effective rate of the electrophysiological therapy group was better than that of the glucocorticoid therapy group. After 6 months of treatment in the electrophysiological treatment group, the efficacy of simple lichen is also better than that of sclerotic lichen.Conclusions: Conventional hormone therapy is easier for patients to accept because of its convenience and low costs.

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Erosive Vulvar Lichen Planus and Risk of Vulvar Neoplasia

Cited by 9 publications

References 28 publications

Risk of Development of Vulvar Cancer in Women With Lichen Sclerosus or Lichen Planus: A Systematic Review

Risk of Development of Vulvar Cancer in Women With Lichen Sclerosus or Lichen Planus: A Systematic Review

Executive Summary of the Lower Anogenital Tract Cancer Evidence Review Conference

Comparison of electrophysiology therapy and glucocorticoid therapy in the treatment of 2 subtypes of vulvar epithelial non-neoplastic lesions: a prospective cohort study

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