The condition affects adult women and the lesions may last for years.
Clinical features:
(1) The patient has a circumscribed, fixed, erythematous patch or plaques on the vulvar mucosa with a shiny surface
(2) Lesions may also appear on the labia, clitoris, fourchette, urethral meatus and vaginal meatus
(3) Lesions may be accompanied by burning, pruritis or dyspareunia.
Histology is required for diagnosis:
(1) A biopsy of the lesion shows a band –like plasma cell infiltrate in the submucosa.
(2) Other findings include crowding of basal keratinocytes, intra-epithelial neutrophils and hemorrhage with hemosiderin deposition.
Diagnosis requires exclusion of alternative diagnoses including:
(1) Behcet’s disease
(2) syphilis
(3) lichen sclerosus et atrophicus
(4) erythroplasia of Queyrat
(5) contact allergy
(6) Candidiasis
(7) fixed drug eruption
(8) pemphigus vulgaris
