Older names for lichen sclerosus (LS) include lichen sclerosus et atrophicus, kraurosis vulvae (in women) and balanitis xerotica obliterans (in males). It may follow or co-exist with another skin condition, most often lichen simplex, psoriasis, erosive lichen planus, vitiligo or morphoea. Lichen sclerosus primarily involves the non-hair bearing, inner areas of the vulva. Lichen sclerosus of anogenital sites is associated with an increased risk of vulval, penile or anal cancer (squamous cell carcinoma, SCC). What treatments may or may not be used in genital psoriasis? The presentation will vary according to the site involved and may range from plaques on the external genitalia to fissures in between the buttocks. Psoriasis of the vulva – commonly appears to be smooth, non-scaly and red. Men may find it difficult to have an erection because their penile skin may be painful, tender, have cracks or bleed. The condition most commonly occurs on the vulva and around the anus with ivory-white elevations that may be flat and glistening. On the non-genital skin, the disease may manifest as porcelain-white spots with small visible plugs inside the orifices of hair follicles or sweat glands on the surface. Penile cancer among patients with genital lichen sclerosus.
Bowenoid papulosis is a cutaneous condition characterized by the presence of pigmented verrucous papules on the body of the penis. Other terms used to describe the condition are: Erythroplasia of Queyrat, Squamous cell carcinoma in situ and Bowen’s disease. It can comprise genital skin folds as part of genital psoriasis, and it is one of the most commonly seen dermatoses of this area. The authors present a 42-year-old female patient with erythematous plaques in the vulva, groin, and perianal region. Anogenital LS is associated with an increased risk for squamous cell carcinoma of the vulva or penis. LS are quite subtle and may overlap with those seen in psoriasis or LP, with luminal hyperkeratosis and hypergranulosis of the adnexal structures, mild irregular, occasionally psoriasiform acanthosis, and focal basement membrane thickening.
The term vulva refers to the external genital organs of the female as a whole. 5 Vulvar papillae were first described in 1981 as pseudocondylomata of the vulva12 and have since been described with several names, including micropapillomatosis, benign squamous papillomatosis, hirsutoid papillomatosis of the vulva, and micropapillomatosis labialis. 72 75 Vulvovaginal lichen planus can take different clinical forms, but given the nature of the anogenital mucosa, the most common findings are intense erythema affecting the introitus and vagina, whitish striae (Fig. Therefore, this article begins with definitions of terms used to describe the most common dermatologic appearances. The male external genitalia are composed of the penis and scrotum. HPV in mucosal skin, covering external genital warts, anogenital pre-cancers and cancers.
Dermatologic and systemic disorders occur in the anogenital region. Psoriasis Vulgaris. Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. The relationship of cervical cancer and sexual behavior was suspected for more than 100 years and was established by epidemiologic studies in the 1960s. Anogenital mucosal HPV infections are highest among college-aged women and men. They may be observed in the perianal area, vaginal introitus, vagina, labia, and vulva. Penile Cancer Recurrent Respiratory Papillomatosis Surgical Treatment of Vaginal Cancer Surgical Treatment of Vulvar Cancer Urethral Warts. Psoriasis (Plaque) Seborrheic Keratosis Malignant Tumors of the Mobile Tongue. Tissue biopsy can be used to confirm HPV infection if the diagnosis is uncertain, particularly if warts are abnormally pigmented, ulcerated, or indurated. Drug Name Imiquimod (Aldara) — Induces secretion of interferon alpha and other cytokines. Pityriasis amiantacea is commonly seen in psoriasis but can be encountered in seborrheic dermatitis, atopic eczema, and pityriasis rosea. The infection produces ulceration at the primary site of inoculation which is usually genital but may be oral, anal, or at other extra- genital locations. Figure of 8 or hour glass appearance is classically described in lichen sclerosus et atrophicus of the female ano-genital region due to a characteristic pattern of sites involved i. Overview of Anal HPV Infection, Anal Intraepithelial Neoplasia, and Anal Cancer Patrick Brill-Edwards, M. 11- 16-, and 18-related cervical, vulvar, and vaginal cancer and the related precancerous lesions, and for the prevention of HPV 6- and 11-related genital warts; in males 9 through 26 years of age for prevention of HPV 6- and 11-related genital warts. To those of us in the HPV world, I think we are a little bit used to them by now, but they never fail to amaze me personally.