Labia leukoplakia, you need to know the cause and treatment

The labia is one of the external organs of the female reproductive organs. In daily life, the labia plays a role in protecting the female reproductive organs and helping women to isolate themselves from external bacterial contamination. However, poor hygiene management of the labia can also lead to labia lesions. What are the causes of white spots on the labia? Let's take a look.

Benign keratotic lesions in the vulva are called white keratosis. White keratosis that does not heal for a long time may further develop into vulvar leukoplakia. The cause of the disease is unclear, but it may be related to systemic factors, such as diabetes and endocrine disorders. The local environment of the vulva, such as moisture, heat and other physical stimulation, can induce vulvar leukoplakia. Histopathology shows proliferative lesions of the mucosal epithelium or epidermis. Under normal circumstances, the vulvar mucosa has no granular layer and stratum corneum. If white keratosis or vulvar leukoplakia occurs, the granular layer will be thickened. If it occurs in the transitional area of ​​the skin and mucosa of the labia majora, there will be obvious hyperkeratosis, thickening of the granular layer, and hypertrophy of the spinous layer. About 80% of the lesions are benign white keratosis, and there is no acanthocyte atypia in the spinous cell layer, and generally no dyskeratinized cells. Under the epidermis is chronic inflammatory cell infiltration.

In vulvar leukoplakia, early metamorphosis can be seen, that is, some spinous cells appear amorphous, the nuclear size is inconsistent, the cell size is also inconsistent, the spinous cells are arranged disorderly, there are dyskeratotic cells in the superficial layer of spinous cells, called malignant dyskeratotic cells, there are varying degrees of inflammatory cell infiltration in the dermis, and there is no pure degeneration of collagen fibers in the superficial dermis.

This disease often occurs in middle-aged or postmenopausal women. It first occurs on the inner and outer sides of the labia minora and the clitoris, and then extends to the inner side of the labia majora, showing grayish-white patches with keratinized, rough, and even cracked surfaces, accompanied by infiltration and hypertrophy, and severe itching. The damage caused by white keratosis and vulvar leukoplakia differs only in the degree of severity, and the diagnosis still needs to rely on pathological examination. Clinically, white keratosis is pale white spots with hypopigmentation, no infiltration or mild infiltration, unclear boundaries, and mild itching; while vulvar leukoplakia is white thickened infiltrated plaques with clear boundaries, cracks, and small patches of erosion and ulcers in some cases. Vulvar leukoplakia is a precancerous lesion with a canceration rate of 4%-10%. It can be diagnosed based on clinical and pathological findings, but needs to be differentiated from vulvar lichen sclerosus and atrophic lichen, which is characterized by atrophic blue-white flat papules that merge into pale white hypopigmented macules, accompanied by adhesion and atrophy of the labia minora. Histopathologically, the epidermis is atrophied and the collagen fibers in the superficial dermis are uniformly degenerated, so it can be differentiated.

treat:

[Oral]: nourishing yin and kidney, nourishing blood and qi, removing dampness, cooked rehmannia 18g, cornus fruit 12g, Chinese yam 20g, moutan bark 15g, Poria 18g, oriental rhizome 12g, sapodilla thorn 12g, three-edged 18g, salvia miltiorrhiza 18g, codonopsis pilosula 18g, astragalus 15g, atractylodes 10g, Polygonum multiflorum 15g

[External wash]: Sophora flavescens 30 g Dafeiyang 20 g Sanguisorba officinalis 20 g Rhubarb 15 g Kochia scoparia 25 g Nepeta tenuifolia 15 g Licorice 10 g Cnidium monnieri 30 g Alum 15 g