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Abstract Vulval dystrophy is a group of chronic conditions affecting older women. In these disorders the skin of the vulva appears white, mottled red and white. These lesions include what was called in the past leukoplakia, lichen sclerosus sclerotic dermatitis hypertrophic kraurosis vulvae. et atrophicus, vulvitis and The characterize maturation. term dystrophy is introduced these disorders of epithelial growth to and The International Society for the Study of Vulval Diseases classified these lesions into: hyperplastic dystrophy recognizable histologically by hyperkeratosis and acanthosis with elongation of rete pegs, these hyperplastic dystrophies may be with or without atypia; lichen sclerosus which is characterized by a thin epithelium beneath which there is a homogeneous zone of dermis; and mixed dystrophy where there is areas of lichen sclerosus with areas of hyperplastic lesions, this also may be with or without atypia. The incidence of vulval dystrophies was reported as 12.6% of all vulval diseases: where 9.5% were hyperplastic dystrophies, 84.4 were sclerosus and 5.7% were mixed dystrophy. lichen The epithelial changes of vulval dystrophies vary from simple benign hyperplastic or atrophic epithelial changes to the development of carcinoma in situ, especially in cases in which there is severe degrees of atypia. It was reported that 5% of patients with vulval dystrophies would have carcinoma in the initial biopsy, and 5% develop carcinoma subsequently, and all of these would show atypia the intial biopsy. |