Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2017 Aug 20;3(4):225-227.
doi: 10.1016/j.ijwd.2017.07.002. eCollection 2017 Dec.

Vulvar lichen planus pemphigoides

J Loyal  1 , S Rashtak  2
Affiliations
Case Reports

Vulvar lichen planus pemphigoides

J Loyal et al. Int J Womens Dermatol. .

Abstract

Lichen planus pemphigoides (LPP) is a rare blistering disease with features of both lichen planus and bullous pemphigoid. LPP typically appears on the extremities and occasionally involves the oral mucosa. Herein, we describe a case of LPP of the vulva of an 80-year-old woman, an uncommon location for this disease process. This clinical scenario can be confused with a number of similarly appearing entities such as erosive vulvar lichen planus, mucous membrane pemphigoid, and erosive lichen sclerosus et atrophicus. In fact, our patient carried a diagnosis of lichen sclerosus by an outside physician for 2 years prior to being properly diagnosed and treated. A detailed discussion of the epidemiology, clinical, and pathogenesis as well as the histologic and immunofluorescence characteristics of this uncommon diagnosis is presented. Our case emphasizes the necessity of microscopic analysis to differentiate lookalike disease states when making a diagnosis and choosing the correct therapeutics.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Genital examination: Vulva shows white and erythematous patches on bilateral labia with a small area of white lacy striae (black arrow) and erosion (white arrow).
Fig. 2
Fig. 2
Oral examination: Recession of maxillary and mandibular gingiva with mild white sloughing (yellow arrow).
Fig. 3
Fig. 3
Subepidermal clefts and band-like lymphocytic infiltrates with melanophages of vulva (hematoxylin–eosin; × 200 original magnification).
Fig. 4
Fig. 4
Subepithelial clefts and lymphocytic infiltrates of maxillary gingiva (hematoxylin–eosin; × 200 original magnification).
Fig. 5
Fig. 5
Direct immunofluorescence shows linear immuglobulin G positivity on the basement membrane zone of the vulva.
Fig. 6
Fig. 6
Salt-split direct immunofluorescence is immuglobulin G-positive on the epidermis of the vulva.
See this image and copyright information in PMC

References

    1. Allen C.M., Camisa C., Grimwood R. Lichen planus pemphigoides: Report of a case with oral lesions. Oral Surg Oral Med Oral Pathol. 1987;63:184–188. - PubMed
    1. Archer C.B., Cronin E., Smith N.P. Diagnosis of lichen planus pemphigoides in the absence of bullae on normal-appearing skin. Clin Exp Dermatol. 1992;17:433–436. - PubMed
    1. Chan L.S., Ahmed A.R., Anhalt G.J., Bernauer W., Cooper K.D., Elder M.J. The first international consensus of mucous membrane pemphigoid. Arch Dermatol. 2002;138:370–379. - PubMed
    1. Cooper S.M., Dean D., Allen J., Kirtschig G., Wojnarowska F. Erosive lichen planus of the vulva: Weak circulating basement membrane zone antibodies are present. Clin Exp Dermatol. 2005;30:551–556. - PubMed
    1. Keith P.J., Wolz M.M., Peters M.S. Eosinophils in lichen sclerosus et atrophicus. J Cutan Pathol. 2015;42:693–698. - PubMed

Publication types