Lichen planus may involve the female genital tract, either alone or in combination with oral, perianal and/or dermal disease.


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


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