How should vulvar leukoplakia that has lasted for twenty years be treated?

Patient's question:

Suffering from vulvar leukoplakia for nearly twenty years

Doctor's answer:

Vulvar leukoplakia is a condition characterized by pigment changes and degeneration in the skin and mucous membrane tissues of the vulva, primarily presenting with vulvar itching as its main symptom. It is a benign exogenous disease primarily involving squamous epithelial cell hyperplasia with an unknown etiology, more common in women under the age of 50, while international reports suggest it is more prevalent in postmenopausal women, with a malignancy rate of 2% to 5%. Due to the unknown cause, there is no specific clinical treatment. In the absence of pre-cancerous lesions or cancer transformation, medication or physical therapy may be used. A 1% hydrocortisone ointment or a 0.3% progesterone ointment can be applied, which often alleviates symptoms but requires long-term follow-up. Physical therapy options include the use of the Hype (Hype knife) or BOM light, among others.