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Genital erosive lichen planus: a review of the literature

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Author(s): Marta Rodrigues

Journal: Acta Obstetrica e Ginecologia Portuguesa
ISSN 1646-5830


ABSTRACT
Erosive lichen planus is one of the three types of lichen planus that affect the vulva. Several factors have been implicated in the etiology of this chronic inflammatory dermatosis, including autoimmunity, drugs and liver disease. Patients usually present with glassy, brightly erythematous erosions, displaying white striae or a white border (Wickam's striae). Erosive lesions are associated with severe symptoms affecting the vulvovaginal and often the oral mucosa, such as pruritus, dyspareunia, abnormal discharge and extreme superficial discomfort. Other inflammatory and erosive vulvar conditions may mimic erosive lichen planus and should be excluded before establishing the diagnosis. Efficient management is usually multidisciplinary, involving dermatologists, gynecologists and stomatologists. Ultra potent topical corticosteroids are considered the treatment with the best evidence of efficacy. Immunomodulators tacrolimus and cyclosporine are second line treatments. The condition is not believed to be premalignant.

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