Vulval leukoplakia – part 2

Pathogenesis:

It is a mucosal or epidermal epithelial proliferative lesion.

In leukoplakia mucosal epithelium becomes keratinized ranging from granular layer thickness.

Histopathological features:

-Significant hyperkeratosis

-Granular layer thickening

-Mucosal or skin epithelial hyperplasia

-Acanthosis thickening

-Epithelial crest

-Infiltration of dermal lymphocytes and plasma cells

-Appearance of prickle cell layer

-Cells with irregular shape and mitotic figures

squamous hyperplasia

Symptoms and signs:

-Patient will usually present with irregular milky white shiny patches or plaques with slightly elevated mucosal surface, well defined borders and state clearly.

These lesions can be seen on genital organs like vaginal mucosa, urethral mucosa, clitoris, labia majora, labia minora etc.

Itching is one more common feature.

Itching can lead scratching, rubbing which can in turn lead to flushing, edema, erosion, ulcers or liquenification.

With progression of time some lesions can become:

-Uplifted, state unclearly

-Surface becomes more keratinized, rough and hard to touch.

-Bleeding from the erosion or ulcers can be seen.

Diagnosis:

Histopathological examination and clinical features collectively help in diagnosis.