ePlasty: Vol. 19
Management of Vulval Lichen Sclerosus—The Role of the Plastic Surgeon
Sameer Gujral, MBChB, BSc, MRCS, James Coelho, MBBS, MSc, MRCS, Shaheel Chummun, MBBS, MSc, FRCS(Plast), and Andrew Watts, MBBS, MS, BSc, FRCS(Plast)

Department of Plastic Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom


Correspondence: sameergujral@yahoo.com
Keywords: vulval, lichen, sclerosus, skin, graft

DESCRIPTION

A 45-year-old woman with vulval lichen sclerosus underwent excisional surgery with healing by secondary intent after several treatments of topical steroids failed. Recurrent disease and scarring led to a narrowed introitus, persistent discomfort, and dyspareunia. Plastic surgery referral led to reexcision and split skin grafting (SSG) with improved symptoms and quality of life.

QUESTIONS

1. What is vulval lichen sclerosus?

2. How does it present and how is it diagnosed?

3. What is the management of vulval lichen sclerosus?

4. What is the potential role of plastic surgery in treatment?

DISCUSSION

Lichen sclerosus (LS) is a chronic inflammatory dermatosis of unknown cause, resulting in white plaques with epidermal atrophy and scarring. It most commonly affects genital areas (80%-85%) but has extragenital manif .......