Diagnosis and Management of Vulvovaginal Lichen Planus.
Obstet Gynecol Surv 2021;
75:624-635. [PMID:
33111963 DOI:
10.1097/ogx.0000000000000834]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Importance
Genital lichen planus is a debilitating disorder that lacks definitive recommendations regarding diagnosis and treatment.
Objective
The aim of this study was to present best practices from available evidence for the diagnosis and treatment of genital lichen planus.
Evidence Acquisition
We conducted a narrative review of the literature on genital lichen planus by searching PubMed using the following search terms: "vulvar lichen planus" OR (vulvar diseases[mesh] OR vulva[mesh]) AND lichen planus[mesh] OR vulvar[ti] AND "lichen planus"[ti]. We included all languages and years in the search.
Results
The search resulted in 273 citations that we reviewed for relevancy and selected 60 as the foundation for this review that focuses on genital sites. Diagnosis can be made without biopsy, and when a biopsy is taken, the pathologic findings may be nonspecific. Topical ultrapotent corticosteroids are most commonly used as first-line treatment of genital lichen planus.
Conclusions and Relevance
When patients present with genital lichen planus, a complete review of systems and a thorough physical examination should be performed because of the prevalence of extragenital sites. Treatment of genital disease should start with a topical, ultrapotent steroid, and follow-up visits should occur to ensure improvement and to monitor for adverse drug reactions and malignancy.
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