Vulvar dystrophy: a clinical follow-up.

The vulvar dystrophy is an enigma and one of the most controversial topic as for the pathogenesis, clinical outcome and particularly the malignant potentiality. There has been very few systematic studies regarding vulvar dystrophy in Japan. Vulvar dystrophy with dysplasia is said to be a pre-malignant condition of the vulva. So in our institute a prospective follow-up of 5 months to 4 years was obtained in vulvar dystrophic patients after a conservative protocol of treatment. The initial histological diagnosis revealed 17 patients with squamous hyperplasia (9 patients with dysplasia and 8, without dysplasia), lichen sclerosus in 5 and other dermatoses in 1 patient. "Itching" was the most frequent complaint, encountered in 20 (69%) of the study patient. Amongst these patients 4/5 of lichen sclerosus and 16/18 of squamous hyperplasia and other dermatoses had complete symptomatic relief with testosterone and corticosteroid respectively. Morphologically 22/23 (96%) had more than 50% decrease of the total lesion. In squamous hyperplasia with dysplasia after treatment, the re-biopsy revealed improvement of the dysplasia in all the cases with total disappearance in the mild dysplasia group. So far, vulvar carcinoma did not develop in any of the patient followed in our study who received treatment for vulvar dystrophy. So, for vulvar dystrophy, a benign squamous epithelial disorder of the vulva, steroid hormone therapy is indeed a logical and a consistent one.