Treatment of Leukoplakia of Vagina in Squamous Cell Hyperplasia of the Vulva When First-Line Therapy Has Not Controlled Genital Itching

Clinical scenario

This protocol addresses leukoplakia of the vagina occurring in the context of squamous cell hyperplasia of the vulva (SCHV) — one of the two main non-neoplastic epithelial disorders of the vulva that are collectively referred to as vulvar leukoplakia.

First-line failure — escalation trigger

Standard first-line management of SCHV includes minimising irritants, soap substitution, avoidance of urinary contact, emollient moisturisation, treatment of co-infections, and a course of topical corticosteroid therapy. Escalation to this protocol is indicated when that first-line approach has failed to achieve control of genital itching.

Next-line approach (partial)

When first-line corticosteroid therapy has not controlled symptoms, a locally applied hormonal agent represents an alternative treatment direction. The complete protocol — including agent selection, application guidance, and monitoring considerations for its known adverse-effect profile — is available via the structured regimen below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.5114/pm.2020.99570

Two non-neoplastic epithelial disorders of the vulva – vulvar LS (VLS) and squamous cell hyperplasia of the vulva (SCHV) – are generally referred to as vulvar leukoplakia.

Local oestrogens are another treatment option for SCHV. However, they have serious adverse effects such as increasing the risk of endometrial hyperplasia and overstimulation.

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