The Prevalence of Lichen Sclerosus in Patients With Vulvar Squamous Cell Carcinoma

Abstract

Women with vulvar lichen sclerosus (LS) have an increased risk of developing differentiated vulvar intraepithelial neoplasia and vulvar squamous cell carcinoma (SCC). Our primary aim was to determine the prevalence of LS among women with vulvar SCC. All patients who underwent excision for invasive SCC of the vulva from January 1, 2009 to December 31, 2013 were identified by searching our institution's electronic laboratory information system (n=111). The vulvar excision specimens from these patients were reviewed for the presence of adjacent LS. The grade of the SCC and clinical data were also documented for each case. The proportion of vulvar SCCs with adjacent LS identified on the excision specimen was 0.29 (95% confidence interval, 0.21-0.38). The proportion of patients in our study population who have ever had a histopathologic diagnosis of LS was 0.36 (95% confidence interval, 0.28-0.45). The presence of LS was not associated with the grade of the adjacent SCC. Patients with synchronous LS on excision were older on average than patients without LS. Tobacco users in our population were more likely to have a history of lower genital tract dysplasia, more likely to be younger, and less likely to have LS identified on the vulvar SCC excision specimen. Given the strong association between LS, differentiated vulvar intraepithelial neoplasia, and vulvar SCC, we recommend careful evaluation of these patients from a clinical and pathologic standpoint.

The effect of vulvar lichen sclerosus on quality of life and sexual functioning

“…Treatment of VLS is essential, not only because of its impact on the quality of life and sexual function of the patients but also due to the risk of squamous cell cancer in the long term [3]. Topical and intradermal (intralesional) corticosteroids constitute the first-line treatment of VLS [8].…”

“…Effacement of the labia minora and clitoris are the most frequent deformities encountered in these patients. Long-term lesions bear the risk of transformation to squamous cell carcinoma [3]. Pruritus, dyspareunia, and deformities have the potential to influence patients' psychosexual health and quality of life.…”

Actualización en liquen escleroso vulvar en población adulta

“…Las de bajo grado (LSIL) están asociadas a la presentación de condilomas acuminados de aspecto elevado o a cambios verrugosos aplanados asociados al VPH de bajo riesgo. Mientras tanto, las SIL de alto grado (HSIL) generan lesiones pre cancerígenas asociadas al VPH (14). La neoplasia intraepitelial vulvar diferenciada (dVIN) es la neoplasia no asociada al VPH más comúnmente relacionada con el LEV (15).…”

“…Los VIN diferenciados (menos del 5% de los VIN) suelen ocurrir en mujeres mayores con un inadecuado tratamiento del liquen escleroso o plano. Mujeres con adecuada adherencia al tratamiento del LEV o el liquen plano tienen menor incidencia de CCE vulvar en comparación con aquellas mujeres que han sido inconsistentes con su tratamiento (11,14). Se han reportado casos de melanoma, carcinoma de células basales y carcinoma de Merkel; sin embargo, aún no se ha generado una asociación contundente entre el LEV y estos cánceres (16).…”

Оцінка Білкових Маркерів Злоякісного Потенціалу При Склерозуючому Ліхені Вульви

“…Однак у ряді випадків він може перебігати абсолютно безсимптомно, хворобу виявляє випадково пацієнт або лікар загальної практики під час проведення ПАП-тесту мазка. Це буває небезпечним, оскільки безсимптомне захворювання, не виявлене завчасно пацієнтом, може призвести до появи карциноми [12]. Про зв'язок СЛВ із підвищеним ризиком розвитку раку вульви і піхви йдеться в роботі P. Мета дослідження -провести імуногістохімічну оцінку та дослідження молекулярних біомаркерів p53, p16, Ki-67, які можуть вказувати на передракові зміни вульви.…”