Genital Lichen Planus
Oral lichen planus affects about 1 in 100 of all women nationwide, occurring most commonly in women between the ages of 50 and 60. One in 4,000 women will have vulvar or vaginal lichen planus. About half of women who have oral lichen planus may have vulvar or vaginal lichen planus. However, dentists may miss this diagnosis because they don’t typically ask about genital symptoms. The most common site of lichen planus involvement is the mucosa of the mouth and gums.
What is Lichen Planus?
Lichen planus is an inflammatory autoimmune dysfunction of your skin and mucous membranes. Lichen planus can affect your skin and sometimes the inside of your mouth. As a result, you are left with distinctive skin patterns as well as oral lesions. There is an assumed relationship between the skin and oral lesions caused by lichen planus; almost half of those affected with the oral version of lichen planus also have skin lesions. The onset of lichen planus can be slow or quick. Lichen planus is not a type of cancer, and it is also not an infectious disease. The most common form of lichen planus affecting the vulva and vagina is known as erosive lichen planus or genital lichen planus.
What causes Genital Lichen Planus?
Certain Drugs: Some people develop lichen planus after taking certain medications. These medications include drugs for high blood pressure, diabetes, heart disease, malaria, and arthritis. Antibiotics and anti-inflammatory painkillers can also sometimes cause lichen planus to show up.
- Dental Procedures: Some people who have lichen planus in their mouth may develop it after having an allergic reaction to certain products used during dental procedures.
- Hepatitis C: Some cases of lichen planus are linked to chronic hepatitis c infections. Hepatitis C causes liver disease like cirrhosis and cancer of the liver.
- Unknown: In most cases of lichen planus the cause is not found. Although lichen planus is not caused by stress, sometimes emotional stress can make your lichen planus worse.
Symptoms of Lichen Planus
Erosive lichen planus and vulvovaginal lichen planus both present difficult symptoms. The symptoms of all the different types of lichen planus are confusing and contradictory. Although many patients with vulvar lichen planus have it in their mouth and on their skin, it is possible that you could have the disease in one area without ever having a problem elsewhere on the body. When lichen planus is on the skin, it causes a rash of small purplish bumps on your arms, legs or back.
Erosive Lichen Planus
Glossy bright red erosions and ulcerations involving the skin of your vulva and vagina is a common symptom of erosive lichen planus. Similar to the way lichen planus leaves scarring inside your mouth and on your skin, erosive lichen planus may cause severe scars on your vulva. It can also cause severe erosion and scarring inside of your vagina, which can lead to the destruction and disintegration of the vagina. Vaginal involvement is reported in about 70% of cases of erosive lichen planus.
Vulvovaginal Lichen Planus
Symptoms of lichen planus on the vulva and vagina include:
- Soreness: Burning and rawness are common symptoms. Itching may also occur although it is less common. If outer areas of your skin break down, these areas (erosions) will appear moist and red.
- Painful Intercourse
- Pallor: Your vulva may appear pale pink or white. Scarring and loss of your labia minora may be seen. Your clitoris may even be buried under scar tissue.
If you are affected on your vulva and vagina by non-erosive lichen planus you will be confronted with the following symptoms:
- Bleeding After Intercourse
- Copious Yellow Discharge
- Destruction of Vulvovaginal System
If a physician examines your case of vulvovaginal lichen planus, he or she will note that the vaginal mucosa will easily bleed and tear while affected by this disease.
Diagnosing Genital Lichen Planus
Dermatologist, oral surgeons, and dentists are the most common type of doctor to diagnose lichen planus, mostly because it occurs inside or around your mouth. Genital lichen planus is most often diagnosed by a gynecologist. To test if your condition is genital lichen planus or lichen planus, a biopsy of a small amount of your tissues from your sores will be collected and tested to rule out a yeast infection, cancer, and other possible causes of your rash.
There are no guidelines to prevent genital lichen planus, other than avoiding any medications that may have triggered it in the past.
Treating Genital Lichen Planus
The known treatments for lichen planus are as follows:
- Immunomodulating Medications
- Soothing Oatmeal Baths
- Topical and Oral Anesthetics
- Topical Anti-Itch Medications
- Topical or Injected Steroids
- Ultraviolet Light and Oral Medication
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