Vulvar white lesions, commonly known as vulvar leukoplakia, is a chronic vulvar skin disease, which mostly occurs in the female genitals.
At present, the cause is unknown, and the main symptom is that the vulva is extremely itchy, regardless of season and daytime. Some patients have hypopigmentation of the vulvar skin with occasional hyperpigmentation, while others only feel that the vulva is dry and uncomfortable, with a burning sensation. Depending on the type of lesion, the vulvar skin may be rough, thickened, atrophied, thinned, and weakened, with severe vulvar skin atrophy, and if the vulvar skin is severely atrophied, dyspareunia and local vulvar skin may be cracked, and for patients with a long course of disease, the vulvar skin may appear lichenified, or the labia and clitoris may shrink and disappear.
1. What factors are related to vulvar leukoplakia?
The academic community believes that it may be related to genetic, endocrine, and repeated chronic stimulation of the vulva.
1. About 10-30% of patients with vulvar leukoplakia are caused by genetics, usually with atrophic type, and the patients are mainly young girls. For patients under 15 years of age, genetic factors should be considered first, and the parents should be asked in detail whether there are vulvar leukoplakia patients in their families.
2. Endocrine diseases caused by pathological metamorphosis of endocrine glands and tissues themselves, or endocrine disorders caused by genetics, enzyme defects and immune function, are also common causes of vulvar leukoplakia.
3. About 50% of patients develop the disease due to genital infection and repeated stimulation of inflammation. If vulvar infection and inflammatory stimulation cannot be treated in time, inflammatory secretion infiltrates the perineum, and long-term infection and stimulation will damage the skin and mucous membranes, resulting in redness, swelling, ulceration and degeneration, which will gradually develop into vulvar leukoplakia. It is also the most common cause of vulvar leukoplakia.
2. What should be paid attention to in the treatment of vulvar leukoplakia?
Vulvar leukoplakia is difficult to cure and prone to recurrence, so it requires a long-term process. Therefore, the treatment of vulvar leukoplakia requires attention to the following aspects:
1. General treatment. Before treating vulvar leukoplakia, other disorders should be excluded first. Such as diabetes, pinworm, fungal vaginitis, pelvic inflammatory disease, cervicitis, etc., excision of inflammatory irritation and the possibility of bacterial infection. At the same time as the treatment, it is necessary to do a good job of daily health care. Keep your vulva dry and clean, don't wash your vulva with harsh drugs or soap, choose loose underwear with good breathability, and don't eat spicy or allergenic foods. Regulate your emotions and maintain a positive and optimistic attitude. For those with obvious itching symptoms that cause tension and insomnia, sedatives, sleeping and anti-allergy drugs can be used.
2. Medication. Topical application of glucocorticoids, including hydrocortisone, clobetasol propionate ointment, etc., most of these drugs can only relieve itching symptoms, but the simple drug treatment is long, once the drug is stopped, the disease is easy to recur, and side effects such as vulvar skin atrophy and burning sensation may also occur.
3. Physical therapy. Local physical therapy is the process of removing local abnormal epithelial tissue and destroying nerve endings in the dermis to block the vicious cycle of itching and scratching, and is suitable for patients with severe symptoms or who do not respond to medication. Common methods: focused ultrasound, CO2 laser or ammonia-neon laser, others: Bohm light, liquid ammonia freezing, etc.
4. Surgical treatment. Surgical treatment affects the appearance and local function, and there is a possibility of long-term recurrence, so surgical treatment is generally not used, and it is only suitable for repeated drugs and physical therapy. Those with dysplasia or the possibility of malignant transformation.
5. Follow-up. Vulvar leukoplakia is a stubborn disease that requires durable treatment, patients need to have a certain amount of patience and adhere to regular follow-up, and the follow-up time is better for 3~6 months. Keep an eye on your condition to prevent it from getting worse.
Author: Wang Wantong
Source: Shenyang Maternal and Child Health Hospital
Editor: Zhou Changlin
Proofreader: He Yiming, Chen Zeming
First trial: Jia Shujuan
Review: Xu Jiang