Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations

Gary Ventolini, Ravi Patel, Robert Vasquez Texas Tech University Health Sciences Center Permian Basin, Odessa, TX, USA Objective: Lichen sclerosus (LS) is a chronic progressive inflammatory autoimmune-induced disease that primarily affects the epidermis and dermis of the external genital-...

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Main Authors: Ventolini G, Patel R, Vasquez R
Format: Article
Language:English
Published: Dove Medical Press 2015-05-01
Series:International Journal of Women's Health
Online Access:http://www.dovepress.com/lichen-sclerosus-a-potpourri-of-misdiagnosed-cases-based-on-atypical-c-peer-reviewed-article-IJWH
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spelling doaj-7487d794157a4766b304069f1cb76cab2020-11-25T00:24:03ZengDove Medical PressInternational Journal of Women's Health1179-14112015-05-012015default51151521654Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentationsVentolini GPatel RVasquez RGary Ventolini, Ravi Patel, Robert Vasquez Texas Tech University Health Sciences Center Permian Basin, Odessa, TX, USA Objective: Lichen sclerosus (LS) is a chronic progressive inflammatory autoimmune-induced disease that primarily affects the epidermis and dermis of the external genital-anal region. Intense and recalcitrant pruritus is the hallmark of LS. Physical exam reveals thinning, hyperkeratosis, and parchment-like appearance. However, the classic symptom and signs of LS may not always be present and patients may be asymptomatic for pruritus. Hence, we describe 15 misdiagnosed cases with atypical clinical presentations. We believe that the absence of pruritus contributed to their initial misdiagnosis. The purpose of this paper is to increase awareness of atypical presentations of LS. Methods: Data base review of de-identified clinical case pictures was performed. All patients had histopathology-confirmed diagnoses of LS. The data base file contains 800 cases of vulvovaginal disorders. The Institutional Review Board (IRB) considered that searching a de-identified data base of pictures did not require IRB approval. Results: We identified 15 different atypical clinical cases. Patient ages were 18–75 years old. These patients were asymptomatic for pruritus and were misdiagnosed before they presented to the vulvovaginal specialized clinic. Conclusion: Fifteen patients asymptomatic for pruritus with histopathology-confirmed diagnosis of LS were identified. They illustrate atypical clinical presentations that LS may have. Keywords: vulvovaginal, vulvar, atypical, lichen sclerosus, asymptomatichttp://www.dovepress.com/lichen-sclerosus-a-potpourri-of-misdiagnosed-cases-based-on-atypical-c-peer-reviewed-article-IJWH
collection DOAJ
language English
format Article
sources DOAJ
author Ventolini G
Patel R
Vasquez R
spellingShingle Ventolini G
Patel R
Vasquez R
Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations
International Journal of Women's Health
author_facet Ventolini G
Patel R
Vasquez R
author_sort Ventolini G
title Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations
title_short Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations
title_full Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations
title_fullStr Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations
title_full_unstemmed Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations
title_sort lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations
publisher Dove Medical Press
series International Journal of Women's Health
issn 1179-1411
publishDate 2015-05-01
description Gary Ventolini, Ravi Patel, Robert Vasquez Texas Tech University Health Sciences Center Permian Basin, Odessa, TX, USA Objective: Lichen sclerosus (LS) is a chronic progressive inflammatory autoimmune-induced disease that primarily affects the epidermis and dermis of the external genital-anal region. Intense and recalcitrant pruritus is the hallmark of LS. Physical exam reveals thinning, hyperkeratosis, and parchment-like appearance. However, the classic symptom and signs of LS may not always be present and patients may be asymptomatic for pruritus. Hence, we describe 15 misdiagnosed cases with atypical clinical presentations. We believe that the absence of pruritus contributed to their initial misdiagnosis. The purpose of this paper is to increase awareness of atypical presentations of LS. Methods: Data base review of de-identified clinical case pictures was performed. All patients had histopathology-confirmed diagnoses of LS. The data base file contains 800 cases of vulvovaginal disorders. The Institutional Review Board (IRB) considered that searching a de-identified data base of pictures did not require IRB approval. Results: We identified 15 different atypical clinical cases. Patient ages were 18–75 years old. These patients were asymptomatic for pruritus and were misdiagnosed before they presented to the vulvovaginal specialized clinic. Conclusion: Fifteen patients asymptomatic for pruritus with histopathology-confirmed diagnosis of LS were identified. They illustrate atypical clinical presentations that LS may have. Keywords: vulvovaginal, vulvar, atypical, lichen sclerosus, asymptomatic
url http://www.dovepress.com/lichen-sclerosus-a-potpourri-of-misdiagnosed-cases-based-on-atypical-c-peer-reviewed-article-IJWH
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