Treatment of Leukoplakia of Vagina in Vulvar Lichen Sclerosus

Clinical Scenario

This protocol addresses vaginal leukoplakia occurring in the specific context of vulvar lichen sclerosus (VLS) — one of the non-neoplastic epithelial disorders of the vulva generally referred to as vulvar leukoplakia. Managing this combination requires a careful, staged approach given the chronic and recurrent nature of the underlying condition.

Condition Context — Vulvar Lichen Sclerosus

Vulvar lichen sclerosus is a chronic inflammatory dermatosis that can present alongside vaginal leukoplakia. Its recognition in this context is clinically important because it influences both the risk profile and the management strategy, particularly when conservative measures are under consideration.

Treatment Approach — Partial Overview

When conservative management has been exhausted, surgical intervention may be considered in carefully selected cases — with specific contraindications and scenario restrictions that guide which procedures are appropriate and which should be avoided. The full protocol defines the exact indications, exclusions, and surgical decision criteria.

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.

If all conservative treatment measures have failed, surgical treatment is indicated.

Surgical treatment of both diseases should be avoided because of recurrence risk and should only be used in certain cases, such as patients with malignancy, or to correct irreversible scarring, adhesions and micturition difficulties or sexual dysfunction caused by the subsequent anatomical changes.

However, vulvectomy and skinning vulvectomy should be avoided because of recurrence rates and disfigurement.

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