Day et al reported diagnostic criteria for vulvar erosive lichen planus. The authors are from the University of Newcastle, John Hunter Hospital, University of Florida, Omnicare Women's Health (Auckland) and Pathology NSW Hunter New England.
Exam: clinical exam and histopathologic
A vulvar biopsy should be taken from a morphologically distinct area.
Criteria for erosive lichen planus - all of the following:
(1) well-demarcated glazed red macule or patch, located vestibule, labia minora and/or vagina
(2) nonkeratinized squamous epithelium, mucocutaneous junction and/or adjacent hairless skin
(3) band-like lymphocytic infiltrated, closely applied to the epithelium
(4) basal layer damage
(5) absence of sclerosis
Basal layer damage may show:
(1) a degenerative pattern (apoptotic bodies, vacuolar change, squamatization)
(2) a regenerative pattern (increased nuclear to cytoplasm ratio, mitotic activity, diminished epithelial maturation)
