Patient's question:
Gender: Female Age: 40Vulvar leukoplakia (atrophic)
20-year history
Doctor's answer:
Hello: "Leukoplakia of the external genitalia" refers to epidermal hyperplasia caused by lesions, loss of pigment in the basal epidermal layer, and reduced superficial dermal blood vessels, leading to a decrease in color or white appearance of the skin or mucosa of the external genitalia. Women suffering from "leukoplakia of the external genitalia" often fear that it may be a precancerous lesion. In recent years, extensive clinical experiments have confirmed that its canceration rate is only about 2%. In 1975, the International Society for Vulvar Diseases decided to abolish the term "leukoplakia of the external genitalia" and referred to the disease as "white lesions of the external genitalia" or "chronic vulvar dystrophy." Patients with white external genital skin often remain unaware due to the lack of sensation, and the condition is usually discovered by a doctor. Some patients, however, may notice it during a visit to the clinic due to itching in the external genital area. Why does the external genital skin turn white? The exact cause remains unclear, but it is relatively well understood that when the external genital skin suffers from certain diseases, the epidermis in the affected area becomes excessively keratinized, and the reduction in melanocytes leads to whitening. The affected skin may thicken like leather, or it may become thin, dry, and prone to cracking, even developing ulcers or hard nodules. If the external genital skin turns white, whether or not there is itching, it is advisable to seek medical examination. Particular attention should be paid if the skin is thickened, rough, elevated, ulcerated, cracked, or hardened, and surgical treatment may be necessary if needed. Since "white lesions of the external genitalia" are relatively stubborn, long-term treatment and regular follow-ups are essential. Follow-up intervals of 3 to 6 months are recommended. With persistent treatment, generally satisfactory results can be achieved. Medication can include vitamin supplements. If the itching is severe and affects sleep, mild sedatives may be appropriately prescribed. Locally, 1% hydrocortisone and 1–2% testosterone cream can be applied.