eMedicine Specialties > Obstetrics and Gynecology > General Gynecology

Nonneoplastic Epithelial Disorders of the Vulva: Follow-up

Author: Michel E Rivlin, MD, Professor, Coordinator of Quality Assurance/Quality Improvement, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine
Contributor Information and Disclosures

Updated: Jul 9, 2007

Follow-up

Further Outpatient Care

  • Generally, patients should have follow-up visits at monthly intervals initially and at 3- to 6-month intervals after a sufficient degree of improvement is achieved.

Complications

  • Lichen sclerosus may result in superficial vulvar atrophy with narrowing of the introitus sufficient to prevent satisfactory intercourse.
  • Squamous cell carcinoma may occur.

Prognosis

  • Lichen sclerosus usually responds to adequate therapy in a month or less. Long-term follow-up care is necessary.
  • Squamous hyperplasia usually responds to adequate therapy within 2-3 weeks, and treatment usually is curative.

Patient Education

  • Counsel patients regarding the importance of regular follow-up care.
  • Early return for assessment is advised if a nodule enlarges or an ulcer remains unhealed.
  • Persistent pruritus should be reassessed if not responding to adequate therapy.

Miscellaneous

Medicolegal Pitfalls

  • Delay in diagnosis of squamous cell cancer may best be avoided by regular assessment and liberal recourse to diagnostic biopsy.

Special Concerns

  • Lichen sclerosus may occur in prepubescent girls. In such cases, treatment should be coordinated with the pediatrician and/or pediatric dermatologist. The principals of therapy are similar to those in the adult with the exception of androgen therapy, which is contraindicated.
 


More on Nonneoplastic Epithelial Disorders of the Vulva

Overview: Nonneoplastic Epithelial Disorders of the Vulva
Differential Diagnoses & Workup: Nonneoplastic Epithelial Disorders of the Vulva
Treatment & Medication: Nonneoplastic Epithelial Disorders of the Vulva
Follow-up: Nonneoplastic Epithelial Disorders of the Vulva
References
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References

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Further Reading

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Keywords

vulvar dystrophy, vulvar disease, kraurosis vulvae, leukoplakia, lichen sclerosus et atrophicus, squamous cell hyperplasia, squamous cell carcinoma, SCC, human papillomavirus, HPV

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Contributor Information and Disclosures

Author

Michel E Rivlin, MD, Professor, Coordinator of Quality Assurance/Quality Improvement, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine
Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, and Royal College of Surgeons of Edinburgh
Disclosure: Nothing to disclose.

Medical Editor

Steven David Spandorfer, MD, Assistant Professor, Department of Obstetrics and Gynecology, New York Presbyterian Hospital, Weill Medical College-Cornell University
Steven David Spandorfer, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine, and Endocrine Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

David Chelmow, MD, Professor of Obstetrics and Gynecology, Tufts University School of Medicine; Program Director, Tufts University Affiliated Hospitals Obstetrics/Gynecology Residency Program; Chair, Tufts University Health Sciences Campus Institutional Review Board; Vice Chair for Research and Education, Department of Obstetrics/Gynecology, Tufts Medical Center
David Chelmow, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, Phi Beta Kappa, Sigma Xi, Society for Gynecologic Investigation, and Society for Medical Decision Making
Disclosure: Nothing to disclose.

CME Editor

Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Hancock Medical Center
Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Chief Editor

David Chelmow, MD, Professor of Obstetrics and Gynecology, Tufts University School of Medicine; Program Director, Tufts University Affiliated Hospitals Obstetrics/Gynecology Residency Program; Chair, Tufts University Health Sciences Campus Institutional Review Board; Vice Chair for Research and Education, Department of Obstetrics/Gynecology, Tufts Medical Center
David Chelmow, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, Phi Beta Kappa, Sigma Xi, Society for Gynecologic Investigation, and Society for Medical Decision Making
Disclosure: Nothing to disclose.

 
 
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