Vulval leukoplakia – part 1

 Definition:

Generally benign keratotic white lesions on the vulva are called as vulval leukoplakia or precancerous disease or white spot disease.

In these more are benign or pre-cancerous lesions. Only 4 to 6% can be cancerous.

Nowadays instead of using the general term leukoplakia, one standard nomenclature has developed based on the histopathological findings of the vulval lesions.

And these lesions are called non-neoplastic epithelial disorders in general. And these are subdivided into:

-Squamous cell hyperplasia.

-Lichen sclerosus.

-And other dermatoses.

Causes of leukoplakia:

Exact etiology is not clear. But the possible factors are:

-Systemic factors like:  

    Diabetes

    Endocrine disorders

    Malnutrition

   Vitamin deficiency

   Pituitary-ovarian dysfunction

-EB virus infection

-Candida albicans infection

-HPV infection seen in around 22% of the patients.

-Can be seen in patients with oral leukoplakia.

-P 53 gene mutation leading to cell proliferation.

-Local factors like:

   Genital partial wetness

   Heat stimulation

   Rubbing

  Age related atrophy

-Previous similar lesions

-The skin graft to vulva can also get the lesions.