Vulvar leukoplakia needs to be carefully differentiated from neurodermatitis

Vulvar leukoplakia and neurodermatitis have certain similarities in symptoms, and they should be carefully differentiated clinically to prevent misdiagnosis and delay the best early treatment opportunity for the disease.

1. Identification based on the site of disease onset

Vulvar leukoplakia mainly occurs on the vaginal mucosa, the inner or outer sides of the labia minora, the clitoris, the inner side of the labia majora, etc., and is a white skin lesion. Neurodermatitis mainly occurs on the inner and outer sides of the labia majora, the inner and outer sides of the labia minora, the mons pubis, around the anus, the clitoris, the perineum, etc., and is mainly gray-white plaques.

2. Identification based on tissue lesions

Vulvar leukoplakia is a lesion of the stratum corneum tissue, while neurodermatitis is a lesion of hyperkeratotic tissue.

3. Identify from the changes in the skin layers of the lesion

In patients with vulvar leukoplakia, the granular layer of the skin at the lesion site is thickened, the spinous layer has irregular hypertrophic skin processes that are elongated with anaplasia and dyskeratosis, and the connective tissue in the upper dermis is degenerated.

The granular layer of the skin at the lesion site of patients with neurodermatitis is quite thick, while the spinous layer has hypertrophic skin processes and elongated, while the dermis generally remains unchanged.

4. Identification based on inflammatory infiltration

In patients with vulvar leukoplakia, lymphocytes and plasma cells in the upper dermis of the lesion site will diffusely infiltrate, and only the elastic fibers of the skin in the infiltrated area will be reduced. In patients with neurodermatitis, subepidermal lymphocytes in the lesion site of the skin generally show dense band-like inflammatory infiltration.