Vulvar leukoplakia should be differentiated from sclerosing atrophic lichen

Vulvar leukoplakia is similar to lichen sclerosus and atrophic to a certain extent, and should be carefully differentiated from the following aspects during the diagnosis process.

1. Identification based on the site of disease onset

The main sites of vulvar leukoplakia are the vaginal mucosa, the inner or outer sides of the labia minora, the clitoris, and the inner sides of the labia majora. In addition to the female vulva, the main sites of lichen sclerosus atrophicus are often in the shape of an "8" around the anus. Some patients also have attacks in the armpits or forearms.

2. Identify from lesions in various layers of the skin

The granular layer of the skin at the lesion of patients with vulvar leukoplakia will have a significant tendency to thicken; the spinous layer will have irregular hypertrophic skin processes and prolongation, and symptoms such as anaplasia and dyskeratosis will occur; the basal layer may have punctate liquefaction and irregular arrangement. The granular layer of the skin at the lesion of patients with sclerosing atrophic lichen is generally normal, and a few will have thickening; the spinous layer will have varying degrees of atrophy; and the basal layer will have punctate liquefaction.

3. Identification based on inflammatory infiltration

The inflammatory infiltration of the skin at the lesion site of patients with vulvar leukoplakia mainly occurs in the lymphocytes and plasma cells in the upper dermis, and the infiltration is diffuse; while the inflammatory infiltration of the skin at the lesion site of patients with lichen sclerosus atrophicus mainly occurs in the lymphocytes in the middle dermis, and the infiltration is band-shaped.