Is vulvar leukoplakia a serious disease?

Vulvar leukoplakia is a diffuse white patch that appears on the female vulva. The cause of the disease is closely related to vulvar malnutrition. After vulvar leukoplakia appears, it will appear on the inner thighs, perineum, and near the pubic hair of women. Vulvar leukoplakia is not easy to treat, so many patients suffer from it for a long time and worry that the disease is very serious. So, is vulvar leukoplakia a serious disease?

Vulvar leukoplakia is a benign gynecological disease that is not serious and is usually caused by the body's own immunity or sex hormone deficiency.

What are the symptoms of leukoplakia

1. Typical symptoms of hyperplastic vulvar leukoplakia at each stage

Stage I hyperplastic type: The main symptom is vulvar itching. Some patients experience severe itching, which worsens at night. Scratching often causes redness, swelling, and ulceration, and may cause burning and other discomfort.

Stage II hyperplastic type: Based on the symptoms of stage I, keratinization and hyperplasia appear in the affected area, and mild hypopigmentation appears locally on the vulvar skin (usually on the inner side of the labia majora and minora), in the form of dots or small white papules, with a frosty white surface.

Stage III hyperplastic type: Severe hyperplasia of skin keratinization, repeated shedding of the keratin layer, or scratching causing vulvar irritation, edema, fissures, ulceration and erosion. There may be itching accompanied by pain. Patients feel that the symptoms are severe, but the treatment effect of this type of patients is rapid, just like the Chinese medicine "Yinbansan" in one course of treatment, about 85% of the patients' symptoms are basically eliminated.

2. Typical symptoms of atrophic vulvar leukoplakia at each stage

Stage I atrophic type: The main symptoms are not obvious. Some patients have mild itching. No white lesions appear, and the vulva has atrophy that is not easily visible to the naked eye.

Stage II atrophic type: The typical symptom is mild visible atrophy of the vulva, usually starting from the labia majora, minora, and clitoris. The elasticity of the labia majora and minora decreases, and the surface wrinkles decrease or disappear. Vulvar pruritus is relatively mild. Due to atrophy, there may be dryness of the vulva, discomfort during sexual intercourse, etc. Localized hypopigmentation occurs on the vulvar skin, in the form of multiple dots or flakes.

Stage III atrophic type: severe symptoms. The labia majora of the vulva are flat, the labia minora disappear, and the clitoris shrinks, becomes smaller or becomes adhered. The urethral opening atrophies, and in severe cases, urinary incontinence occurs. The vaginal opening atrophies, and sexual intercourse becomes difficult. Some patients develop anal leukoplakia and atrophy, causing the skin around the anus to become wrinkled and less elastic, which can lead to anal fissures during defecation. About 50% of patients have large areas of hypopigmentation on the vulvar skin.

3. Symptoms of mixed vulvar leukoplakia

When the disease of patients with hyperplastic and atrophic types of vulvar leukoplakia progresses to the late stage II to stage III, they generally develop mixed symptoms of the two types.

How to treat vulvar leukoplakia

1. General treatment

Pay attention to keeping the vulva clean and dry. Do not use irritating drugs or soaps to clean the vulva. Avoid wearing non-breathable synthetic underwear and do not eat spicy or allergenic foods. For those with severe itching symptoms leading to insomnia, sedatives, sleeping pills and anti-allergic drugs can be added.

2. Medication

Commonly used drugs for vulvar lichen sclerosus include pyruvic acid ointment, compound vitamin A ointment and progesterone ointment. Alternatively, glucocorticoid ointments or immunotherapy may be used. Drugs can improve symptoms but cannot cure the disease, and long-term use is required. Lichen sclerosus in young girls may heal on its own by puberty, and pyruvate ointment is generally not used for treatment to avoid virilization. 1% hydrocortisone ointment or 0.3% progesterone ointment can be applied, which can relieve most symptoms, but long-term follow-up is required.

Vulvar squamous epithelial hyperplasia can be treated with topical corticosteroids to control pruritus. Treatment is effective for most patients, but long-term medication is required.

3. Physical therapy

Suitable for patients who are ineffective with drug treatment or whose condition is serious. Microwave therapy, carbon dioxide laser and helium-neon laser, Bohm light, high-frequency electric knife, local electrocautery therapy and liquid nitrogen local cryotherapy, etc.

4. Surgery

Surgical treatment is only suitable for patients with severe conditions and those who have failed to respond to repeated medication or physical therapy. Surgery is required when vulvar squamous hyperplasia is suspected to be malignant.