According to the American Congress of Obstetricians and Gynecologists educational resources, vulvar dystrophy is the growth of abnormal skin on the vulva. The vulvar skin can be too thin, too thick (hyperplasia), or a mixture of both. There are several types of vulvar dystrophy. Two common types include:
- Squamous cell hyperplasia - an irregular white or gray patch of the skin on the vulva that may be slightly raised
- Lichen simplex chronicus - a thickened white area usually on just one side of the vulva
When the skin becomes too thick, it may appear wrinkled and the vaginal opening may shrink. When thickened it may also appear hard. The exact cause of vulvar dystrophy is not known; however, it may be associated with a prior irritation or inflammatory response.
The symptoms of vulvar dystrophy include: redness or whiteness, itching, and burning in the vulvar region. Some women complain of painful intercourse also known as dyspareunia.
For lichen simplex chronicus (LSC), the vulvar skin may appear to be thickened, white or grey and is usually located only on one side of the vulva. The vulva may also scale, crack and bleed at touch or penetration. It may also have sores.
A diagnosis of vulvar dystrophy can be made with a careful review of a patient's history and a physical examination. It is important to report all symptoms to your health care professional so that he or she can better understand the history of the symptoms.
With lichen simplex chronicus, the patient will report intense itchiness and relief upon scratching; recurrent itchiness does occur however. The skin will become red, thickened, and may exhibit erosion, fissures or have loss of hair in the genital area. Vaginal infections may occur in addition to these conditions so it is also important to rule out vaginitis.
It may be necessary to complete a vulvar biopsy to get a definitive diagnosis. During a biopsy, a small amount of vulvar tissue is removed and sent for pathological evaluation. A numbing medication is used and placed in the area of concern before the biopsy is performed.