Erosive Vulvar Lichen Planus and Risk of Vulvar Neoplasia

J Low Genit Tract Dis. 2021 Jan 1;25(1):71-75. doi: 10.1097/LGT.0000000000000581.


Objective: The aim of the study was to assess the risk of vulvar cancer and precursors in a cohort of women with vulvar lichen planus (LP) and the clinical and therapeutic features of these patients.

Materials and methods: A retrospective cohort study, including all the women with the diagnosis of vulvar LP, followed in one institution during a period of 11 years, was performed. Demographic and clinical data, as well as treatment, follow-up, and histology results, were evaluated.

Results: A total of 127 women were diagnosed with vulvar LP. The mean follow-up time was 3.9 ± 0.5 years (range = 1-11 years). Ultrapotent topical corticosteroids were first-line treatment in 91.8% (n = 112), with 32 cases (25.2%) needing an alternative treatment. Overall, 30 biopsies were performed in 19 women (15%). Vulvar high-grade squamous intraepithelial lesion was diagnosed in 3 women (2.4%), 2 (1.6%) of whom were later diagnosed with vulvar squamous cell carcinoma. No cases of differentiated vulvar intraepithelial neoplasia were observed.

Conclusions: Premalignant/malignant transformation in women with vulvar LP under surveillance and compliant with treatment is low. A close follow-up seems to be crucial to prevent future malignancy. Biopsies should be performed whenever a suspicious lesion seems during follow-up.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Carcinoma, Squamous Cell / pathology
  • Cell Transformation, Neoplastic / pathology*
  • Female
  • Humans
  • Lichen Planus / drug therapy
  • Lichen Planus / epidemiology
  • Lichen Planus / pathology*
  • Middle Aged
  • Portugal
  • Retrospective Studies
  • Risk Factors
  • Vulva / pathology*
  • Vulvar Neoplasms / pathology*


  • Adrenal Cortex Hormones