Lichen planus (LP), despite being described over a century ago, remains a disease of unknown etiology without one single effective treatment, as highlighted in the article by Cooper et al in this issue of the Archives.1 One of the most challenging conditions seen in clinics dedicated to vulval disease is the vulvovaginal-gingival syndrome described by Pelisse et al2 in 1982 that affects the vulval skin and vaginal mucosa. Mucosal LP runs a chronic and debilitating course with painful erosions on the oral and genital mucous membranes, which can have a major impact on the patient's quality of life.3 In addition to the clinically significant symptoms related to the inflammatory process, there are the sequelae of vulval scarring and vaginal stenosis that have an impact on sexual function, as well as a small but definite risk of malignant change. Therefore, effective treatments for relief of symptoms, prevention of scarring, and a reduction in the incidence of malignant change must be sought.
Neill SM, Lewis FM. Vulvovaginal Lichen PlanusA Disease in Need of a Unified Approach. Arch Dermatol. 2008;144(11):1502-1503. doi:10.1001/archderm.144.11.1502