Erosive vulvar lichen planus: a cohort at risk for cancer?

OBJECTIVE: To determine the occurrence of cancer, including vulvovaginal squamous cell carcinoma (SCC), among women after diagnosis of erosive vulvar lichen planus (LP).

STUDY DESIGN: Retrospective review of 113 patients diagnosed with erosive vulvar LP over an 8-year period (average follow-up, 5 years).

RESULTS: A diagnosis of cancer was made in 5 women after diagnosis of erosive vulvar LP. Of these, 1 had stage II vulvar SCC after treatment for stage IIB cervical cancer, and 2 with oral LP had subsequent diagnoses of oral or esophageal SCC. The remaining 2 cancer diagnoses included cervical adenocarcinoma in situ and rectal adenocarcinoma.

CONCLUSION: Of 113 women with erosive vulvar LP, 1 had subsequent development of vulvar SCC. Estimating the risk of SCC among women with vulvar LP is difficult because of the low prevalence of each disorder. Additionally, given the age of the patient and multifocal involvement, association with human papillomavirus was likely. Rather, this cohort exemplifies the need for long-term evaluation in the management of vulvar LP.