Review of squamous premalignant vulvar lesions

Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma

“…In this study, we show that differentiated VIN is not as rare as a solitary lesion as previously believed, but there is significant underdiagnosis. The recognition of differentiated VIN is of utmost importance because the malignant potential of differentiated VIN is considered to be high, 10 and therefore, treatment differs between lichen sclerosus (topical superpotent corticosteroid ointment 27 ) and differentiated VIN (surgical excision 7 ). After exclusion of lesions that were changed into differentiated VIN, we found that lichen sclerosus biopsies with progression more often showed dyskeratosis and parakeratosis, hyperplasia and basal cellular atypia in comparison with lichen sclerosus biopsies without progression.…”

“…[3][4][5] Lichen sclerosus is a chronic inflammatory skin disease and mainly affects the female anogenital area. 6,7 The classical histological findings of lichen sclerosus are a thinned epidermis and/or the loss of rete ridges, hyperkeratosis, edema and/or hyalinization, as well as a chronic band-like inflammatory cell infiltrate of the dermis 8 ( Figure 1a), but there are a lot of variations to these classical histological characteristics, leading to a myriad of lesions that may be classified as lichen sclerosus. Although lichen sclerosus is considered a premalignant condition, only 2-5% of patients with lichen sclerosus ultimately develop a vulvar squamous cell carcinoma.…”

Intraepithelial macrophage infiltration is related to a high number of regulatory T cells and promotes a progressive course of HPV‐induced vulvar neoplasia

“…[1][2][3] Treatment of uVIN lesions is indispensable since 80% of patients suffer from symptoms as pruritis and pain. [2][3][4] Conventional treatment consistent of potential disfiguring surgical interventions is associated with psychosexual problems and is increasingly replaced by either standardized immunotherapy with imiquimod or immunotherapy in experimental setting by therapeutic vaccination or photodynamic therapy, with promising clinical successes. [2][3][4][5][6][7][8] The incidence of hrHPV-induced dysplasia is increased in immunocompromised patients highlighting the essential role of the immune system in viral clearance.…”

“…[2][3][4] Conventional treatment consistent of potential disfiguring surgical interventions is associated with psychosexual problems and is increasingly replaced by either standardized immunotherapy with imiquimod or immunotherapy in experimental setting by therapeutic vaccination or photodynamic therapy, with promising clinical successes. [2][3][4][5][6][7][8] The incidence of hrHPV-induced dysplasia is increased in immunocompromised patients highlighting the essential role of the immune system in viral clearance. 9,10 Spontaneous regression of HPV is associated with systemic HPV-specific CD41 and CD81 immune responses, however in most of the patients with uVIN these T cell responses are either weak or absent.…”

Evaluation of concentration of thyroid antibodies, antinuclear antibody titers and presence of Borrelia burgdorferi antibodies in patients with vulvar lichen sclerosus treated with photodynamic therapy

“…Lokalizuje się głównie w okolicy genitalnej, jednak w kilkunastu procentach przypadków może występować w innej lokalizacji (klatka piersiowa, szyja, kończyny górne, głowa, jama ustna, paznokcie, blizny po zabiegach chirurgicznych) [1,2]. Liszaj twardzinowy częściej diagnozowany jest u kobiet w okresie około-i pomenopauzalnym, występuje też u małych dziewczynek [3].…”