Vulvar leukoplakia makes many women panic. In fact, there are different types of vulvar leukoplakia. Hyperplastic dystrophy may show this symptom, as well as lichen sclerosus dystrophy, which is especially common in women in their forties. 1. Hyperplastic malnutrition It usually occurs in women aged 30 to 60. The main symptoms are unbearable itching of the vulva, which is aggravated by scratching. The range of lesions varies, mainly affecting the labia majora, interlabial groove, clitoral hood and posterior commissure. It is mostly symmetrical. The affected skin is thickened like leather, with raised wrinkles, or scales, eczema-like changes, and the surface color is mostly dark red or pink, mixed with clearly defined white patches, generally without atrophy or adhesion. 2. Lichen sclerosus dystrophy It can be seen at any age, but is more common in women around 40 years old. The main symptom is itching in the lesion area, but it is generally much milder than proliferative lesions. In the late stage, sexual intercourse becomes difficult. The lesions involve the vulvar skin, mucous membranes and skin around the anus. In addition to the skin or mucous membranes turning white, thin, dry and easy to crack, they also lose elasticity. The clitoris often atrophies and adheres to the foreskin. The labia minora flattens and disappears. In the late stage, the skin is thin and wrinkled like cigarette paper, and the vaginal opening is contracted and narrow, only allowing for fingertips. Young girls who suffer from this disease often feel discomfort in the vulva and perianal area after urinating or defecating, and keyhole-shaped, pearly yellow or white lesions appear in the vulva and perianal area. The lesions usually disappear on their own by the time they reach puberty. 3. Mixed malnutrition The main manifestations are the areas adjacent to the thin whitish area of the vulva, or accompanied by focal skin thickening or protrusions within its range. Diagnosis: If the above symptoms and signs are present, diabetes and chronic inflammation caused by fungi should also be ruled out. For further diagnosis, a biopsy should be performed. The biopsy should be taken from the areas with cracks, ulcers, protrusions, nodules or roughness. Samples can also be taken from multiple points. To improve the accuracy of diagnosis, 1% toluidine blue can be first applied to the lesion area, and then it can be scrubbed and decolorized with acetic acid after it dries. Any area that does not decolorize indicates the presence of naked nuclei, indicating that there is a high possibility of finding atypical hyperplasia or cancer in the biopsy at this location. If the lesion area is large, it should be treated for several days first, and then a biopsy can be taken after most of the skin lesions have healed. |
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