Diagnosis of vulvar leukoplakia

Many female friends are afraid of vulvar leukoplakia. Let's learn how to diagnose vulvar leukoplakia so that patients can receive timely treatment and get rid of the pain.

Differential diagnosis: Clinical features of this disease: Itching of the vulva, sometimes with burning and pain. The skin of the affected area is rough, thickened with moss-like appearance, with scratches, and sometimes with fissures. Local hypopigmentation, the labia majora and labia minora generally turn white. Mild atrophy can be seen on the vulva. In severe cases, the clitoris, labia majora and labia minora atrophy and adhesion, the labia minora partially or completely disappear, and then joint tightening, the vaginal opening is narrow, elasticity disappears, and even urination and sexual life are affected.

In addition to the above-mentioned unique symptoms and signs, the diagnosis of this disease should be based on pathological diagnosis as the final conclusion. Because many diseases can cause skin itching and loss or depigmentation of pigments, although the manifestations are different, it is not easy to distinguish them with the naked eye. Even if the naked eye can diagnose, it is not possible to do pathological typing, especially to find atypical hyperplasia (precancerous lesions) early. It has been reported in the literature that about 50% of vulvar squamous cell carcinomas are often accompanied by vulvar white lesions. Therefore, if the lesions are atypical or there are chronic chapped, localized thickening, and ulceration, it is necessary to rely on biopsy pathological examination for diagnosis. When taking samples, it is necessary to take samples from multiple points such as ulcers, chapped, indurated, raised or rough areas, and take samples appropriately. Method: First, apply 1% toluidine blue to the lesion area, wait for it to dry, and then use 1% acetic acid solution to decolorize it. In the non-decolorized area, use biopsy forceps perpendicular to the skin and deep into the dermis to take biopsy. Any area that does not discolor indicates the presence of naked nuclei, suggesting that biopsy in this area can improve the accuracy of diagnosis.

Diagnosis: This disease can occur at any age, and has been reported in various stages of women: childhood, adolescence, menopause and old age, but most cases occur in menopause 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., and are often symmetrical.

Vulvar itching is the first prominent symptom felt by patients, especially at night. The degree of itching is related to time, menstruation, climate, food, environment, and mood. Itching usually occurs intermittently, and patients often scratch because of the itching. Due to scratching, there are many scratches and redness and swelling in the external vagina. As a result of long-term itching, local ulceration, fissures, ulceration and secondary infection occur. Therefore, patients often have local burning pain, especially the clitoris and labia minora are very sensitive. In the early stage, the part is hyperkeratotic and infiltrates the skin. The vulvar skin and mucosa appear localized or diffuse white thickening like leather, raised with wrinkles or scaly, eczematous changes. The skin color of the vulva is mostly purple or light red, but can also be grayish white or grayish blue, with clearly defined white keratinized plaques in different shapes and sizes. It is a mixed malnutrition with mixed symptoms of atrophic and hyperplastic types, with obvious atrophy of the vulva, hypertrophy of the clitoral hood, obvious keratinization, coarse lines of the labia majora, hypopigmentation, and localized thickening and ulceration. The skin of the affected area is rough, thickened like moss, with scratches, and sometimes chapped. Local hypopigmentation, the labia majora and labia minora generally turn white. Mild atrophy can be seen on the vulva. In severe cases, the clitoris, labia majora and labia minora atrophy and adhesion, the labia minora partially or completely disappear, and then joint tightening, the vaginal opening is narrow, elasticity disappears, and even urination and sexual life are affected.

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