White lesions of the vulva before and after perimenopause

Before and after perimenopause, due to the gradual decline of ovarian function to the cessation of ovarian function, the gradual loss of estrogen function caused a series of physiological changes in the external genitalia, mainly atrophic changes to varying degrees. Skin aging usually occurs around the age of 40, with significant changes 5 to 10 years after menopause. Vulvar white lesions refer to a group of diseases caused by dystrophy of the skin and mucous membranes of the female vulva due to nutritional disorders and pigment changes. It is characterized by itching, ulceration, severe pain, and skin changes outside the yin, which is difficult to treat and easily relapses, which brings great pain to the patient. The disease is a chronic disease process with varying lengths of disease, and the elderly can reach decades. As the cause is not clear, nomenclature and treatment methods have not been unified. In the past, vulvar disease with whitening, thickening or atrophy of vulvar skin and mucous membranes was collectively referred to as vulvar leukoplakia, and it was even considered to be a precancerous lesion. Therefore, it was advocated for early resection at that time, and some people thought that it must be atypical in pathological sections Only proliferative cells are diagnosed as vulvar leukoplakia. Due to different diagnostic criteria and different nature and prognosis of the disease, it leads to confusion about the diagnosis and treatment of the disease. In order to unify understanding, many scholars at home and abroad have named and The classification was further retrospectively analyzed and discussed. In 1877, Schwimmer first blushed the oral buccal mucosa and named it white spot after hyperkeratosis. Then Breisky reported in 1985 that similar lesions of the vulva were named vulvar white spot disease. Later Taussig (1923, 1930) specifically classified vulvar white spots. Named early vulvar leukoplakia (hypertrophic phase) and late (atrophic phase), this view has been followed by future generations. In 1961, Oberqield reviewed relevant literature and observed based on his own materials, suggesting that Taussig's vulvar leukoplakia atrophy is actually sclerosis. Atrophic moss, but Clark and Woodruqq applied the nuclide method and 3H (氚) -labeled thymidine measurement confirmed that the thinning epidermis of sclerotic atrophic moss has strong metabolic functions and did not atrophy, so some people think that sclerotic atrophic The name of moss is not enough, the word atrophy should be removed and the name should be changed to sclerosing moss. Some people think that the initial and intrinsic lesions of this disease are damage to the connective tissue fibers and matrix below the epidermis, and the epidermal thinning is secondary. This is in line with the opinions of Oberqield and Stelguler, so from the perspective of the formation mechanism It is believed that the sclerosing moss is named more accurately. For a long time, the whitening of the vulva is clinically referred to as vulvar leukoplakia. In the past 20 years, the concept of leukoplakia has been pathologically limited to those with atypical subcutaneous hyperplasia. The same term has different meanings. In order to avoid confusion, most scholars advocate abandoning White spot of vulva. The 1987 Ninth International Conference on Vulvar Disease proposed a new classification and designation as follows: ① non-neoplastic skin, mucosal epithelial lesions include sclerosing moss, squamous hyperplasia, and other skin diseases; ② vulvar intraepithelial neoplasia (VIN) Including mild, moderate and severe atypical hyperplasia and carcinoma in situ. At present, there is no uniform naming in China. Scholars name and classify according to their own opinions. Some authors believe that the initial clinical diagnosis has failed to determine whether there is an atypical hyperplasia. Therefore, before the medical examination, they can be collectively referred to as vulvar white lesions or vulvar white skin diseases including hyperplasia. Vulvar skin lesions and sclerosing moss, atypical hyperplasia of the vulva, vitiligo such as the vulva.

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