See also: Vulvar lesions
A chronic inflammatory condition of the anogenital region that most commonly affects women.
May have an autoimmune pathogenesis.
Sx
Characterized by
Anogenital discomfort including
Pruritus
Dyspareunia
Dysuria
Painful defecation
PE
Procelain-white polygonal macules and patches with an atrophic, "cigarette paper" quality.
Sclerosus and scarring can lead to obliteration of the labia minora and clitoris and a decrease in the diameter of the introitus.
Dx
The diagnosis can readily be made clinically, however vulvar squamous cell carcinoma occurs more commonly in women with LS&A
When the diagnosis is in question, punch biopsy of any suspicious lesions should be performed
Tx
High-potency topical steroids
A class I topical corticosteroid in oitment form should be applied twice daily for four weeks, at which point transition to a less potent topical steroid or topical calcineurin inhibitor for maintenance therapy is appropriate
