‘Primary gingival and later primary vulval carcinomas arising in lichen planus: report of a case and clinical suggestions for diagnosis of a neglected disease’

Abstract

Lichen planus (LP) is a chronic immune-mediated dermatosis mainly affecting skin, oral, and genital mucosa. The heterogeneous clinical presentation, spectrum of symptoms depending on subtype and overlap with other vulval and cutaneous disorders can lead to challenging in diagnosis. We report an unusual case of vulval SCC arising within a patient with initial oral mucosal lichen planus who later developed lichen planus of the vulva. Discussion of this case is important as it typifies the difficulties in diagnosis of vulvo-vaginal disorders and potential complications. Evidence is available that lichen planus may be potentially precancerous condition and is associated with SCC development. This case may confirm an inherent oncologic potential of the disease. All efforts must be made by specialists involved in the management of this disease to obtain an early diagnosis, ensure proper treatment and adequate follow up. This highlights the need to perform vulval examination in patients with symptoms or with a history muco-cutaneous LP and if necessary consider referral to specialist center for biopsy and management.

摘要

扁平苔藓 (LP) 是一种慢性免疫介导的皮肤病, 主要影响皮肤、口腔和生殖器黏膜。不同类型的临床表现、不同亚型的症状谱以及与其他外阴和皮肤疾病的重叠可能导致诊断上的挑战。我们报告一个不寻常的外阴鳞状细胞癌病例, 该病例最初为口腔黏膜扁平苔藓, 后来发展为外阴扁平苔藓。这个病例的讨论很重要, 因为它代表了诊断外阴阴道疾病和潜在并发症的困难。有证据表明扁平苔藓可能是潜在的癌前状态, 并与鳞状细胞癌的发展有关。这个病例可能证实了该病固有的肿瘤潜能。参与管理这一疾病的专家必须作出一切努力, 以便获得早期诊断, 确保适当的治疗和充分的后续随访。这突出了对有症状或有皮肤粘膜LP病史的患者进行外阴检查的必要性, 如有必要, 考虑转诊到专科中心进行活检和管理。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Lichen planus
• vulvovaginal lichen planus
• gingival carcinoma
• vulval carcinoma
• vulva

Ethical approval

The patient gave written informed consent for the publication and Institutional Review Board approved the publication of the case.

Disclosure statement

No potential conflict of interest was reported by the authors.