- Title
- Is vulvovaginal lichen planus associated with squamous cell carcinoma?
- Creator
- Day, Tania; Otton, Geoff; Jaaback, Ken; Weigner, Julie; Scurry, James
- Relation
- Journal of lower genital tract disease Vol. 22, Issue 2, p. 159-165
- Publisher Link
- http://dx.doi.org/10.1097/lgt.0000000000000384
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2018
- Description
- Objective: The aim of the study was to assess for the presence of vulvar lichen planus (LP) in association with human papillomavirus (HPV)-independent squamous cell carcinoma (SCC). Materials and Methods: We performed a clinicohistopathologic review of consecutive vulvectomies and wide local excisions for HPV-independent vulvar or vaginal SCC from 2007 to 2017. Data collected included site of SCC, adjacent precursor lesions and dermatoses, dermatologic treatment, and outcome. Results: There were 43 cases of primary HPV-independent vulvar SCC treated by excision, but no vaginal cancers. Eighteen women (42%) had a preoperative diagnosis of lichen sclerosus (LS); none had a diagnosis of LP. Topical corticosteroids were prescribed in 19 (44%) of 43, with 4 women placed on maintenance therapy. Tumors arose from the labia minora, labia majora, and periclitoris, but not from vestibule or perianus. On histopathological review, LS was present in 41 (95%) of 43 specimens, 1 had a nonspecific lichenoid reaction, and 1 had lichen simplex; both of the latter had subsequent biopsies showing LS. Conclusions: Lichen planus was not seen in association with SCC. Differentiated vulvar intraepithelial neoplasia (dVIN) was present in 38 (88%) of 43 specimens, whereas 1 had acanthosis with altered differentiation and 4 (9%) had no precursor lesion. Differentiated vulvar intraepithelial neoplasia had standard, basaloid, and hypertrophic morphology, superficially resembling erosive LP in 9 (24%) of 38 and hypertrophic LP in 6 (16%) of 38.Lichen planus was not seen in association with HPV-independent vulvar SCC, whereas LS was underrecognized and inadequately treated in this group. Pathologists should be aware that dVIN may superficially resemble erosive or hypertrophic LP.
- Subject
- lichen planus; lichen sclerosus; differentiated vulvar intraepithelial neoplasia; HPV-independent; vulvar squamous cell carcinoma
- Identifier
- http://hdl.handle.net/1959.13/1422271
- Identifier
- uon:37814
- Identifier
- ISSN:1089-2591
- Rights
- Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society for Colposcopy and Cervical Pathology. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
- Language
- eng
- Full Text
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