Understanding the pathogenesis of vulvar leukoplakia from the perspective of traditional Chinese medicine

Vulvar leukoplakia is more common in menopausal women around the age of 50. The course of the disease varies, and the elderly can last for decades. The most common sites are the clitoris, labia minora and the inner groove of the labia majora, and sometimes occur in the vestibule, vagina, urethral orifice, posterior symphysis, etc., often in a symmetrical manner. Traditional Chinese medicine believes that this disease is closely related to the liver, kidneys, and spleen.

1. Blood deficiency and dryness

The spleen is the source of blood production. Spleen deficiency leads to blood deficiency. Long-term illness consumes qi and blood, resulting in Chong and Ren blood deficiency. The vulva skin loses blood nourishment, causing dry skin and disease. The main characteristics of this type are whitening of the vulva skin, dryness and dullness, and significantly aggravated itching at night.

2. Liver and kidney yin deficiency

Long-term illness or old age, liver and kidney deficiency or excessive sexual activity, kidney essence is damaged, essence and blood are damaged, and the skin cannot be moisturized, resulting in dry vulva. It manifests as itching in the vulva, which is more severe at night, atrophy of the vulva, dry and brittle lesions, and in severe cases, the labia majora is flat, the labia minora disappears, and the vaginal opening is reduced.

3. Spleen and Kidney Yang Deficiency

When the spleen and kidney yang are deficient, internal cold will be generated, and the Chong and Ren meridians will be deficient and cold, the genitals will lose warmth, the yang cold will stagnate on the genitals muscle surface, and the circulation of qi and blood will be blocked. Therefore, the vulvar skin will change color and atrophy, the vulvar skin will turn white, and there will be alternating atrophy, thickening and roughness.

4. Damp-heat in the liver meridian

Long-term unhappiness in women can lead to liver qi stagnation and discomfort, which can turn into heat over time, and damp heat can flow into the lower part of the body, soaking the vulva and causing disease. This type of patient's genital skin and mucosa are hypopigmented, rough, wrinkled, red, swollen and itchy, with yellow discharge from scratched areas, dampness-like changes, local burning pain, and excessive, yellow and smelly vaginal discharge.