Patterns of female genital involvement:
(1) vulvar
(2) vaginal
(3) vulvovaginal
(4) vulvovaginal and oral (vulvovaginal gingival syndrome)
(5) vulvovaginal and perianal (anogenital syndrome)
Vulvovaginal findings - mild disease:
(1) hyperkeratosis
(2) mild desquamative vaginitis with discharge
(3) pain, burning and soreness
(4) pruritis
(5) dysuria
(6) vaginal dryness
(7) dyspareunia
(8) mucosal erythema
(9) mucosal pallor
(10) telangiectasia and/or purpura
(11) white, lacy, reticulate striae
(12) hypopigmented papules and plaques
Vulvovaginal findings - severe disease:
(1) erosions, fissures and ulcerations
(2) synechiae and scarring
(3) stenosis
The diagnosis requires exclusion of:
(1) infectious vulvovaginitis
(2) pemphigus
(3) linear Ig A disease
(4) lichen sclerosus et atrophicus (LS and S)
(5) SLE
