The vulvar skin, like the rest of the body, can develop allergic reactions and autoimmune responses that cause unusual patches or plaques. The appearance and other associated symptoms can help determine the cause of the skin changes. The symptoms may include itching or irritation, pain or discomfort, and flaking skin. On examination, the doctor may find changes in the skin texture, erosions, white patches and areas of redness. A biopsy maybe required to determine the problem however an experienced gynecologist maybe able to diagnose the problem just by looking. The disorders below are some of the more common causes of plaques and patches.

Lichen Simplex Chronicus

This is essentially a dermatitis that has developed from chronic scratching or rubbing. The inciting event could be a yeast infection or an allergic reaction to a chemical. The itch-scratch cycle is a viscous one that is difficult to break. The more you scratch, the more you itch and it is the scratching that leads to the chronic problem.

On examination the skin will appear thickened, flaky and will have white or dark patches depending on the natural skin color. There maybe erosions or excoriations from scratching. Breaking the cycle can solve the problem. Treatment may include local medication to stop the itching and oral medication to decrease the inflammatory reaction. Topical steroid ointment and oral antihistamine medications are the most commonly used. Other recommendations may include: cutting your nails and wearing gloves at nighttime to minimize the trauma of scratching during sleep.

Lichen Sclerosus

Is a condition where the skin of the vulvar is essentially destroyed. The cause is unknown. It presents with itching or irritation that gradually worsens over years and can lead to pain with intercourse. On examination the skin is noted to be thin, wrinkled, and white. The classic description is that it looks like cigarette paper.

Over time the changes can lead to destruction of the normal anatomy. The labia may shrink and disappear and the clitoris may become buried under scar tissue. Minimal trauma can cause tearing.

The goal of treatment is to prevent further damage. The treatment is a high potency steroid ointment applied to the skin of the vulvar. Continued monitoring by an experienced Gynecologist or Dermatologist is required since women with this condition are at a higher risk of developing vulvar cancer.

Vitiligo

Is an autoimmune condition that can affect the whole body. The cells that produce the skin color are called melanocytes. When these cells are destroyed or cannot function then there is a lack of color in this area of the skin. There is a notable, well-circumscribed white patch. The skin is otherwise healthy in appearance. The absence of other symptoms and the findings of white patches in other body areas is an indication that the condition is vitiligo. The treatment is best managed by a Dermatologist.

Other Causes

Other causes of patches and plaques include skin lesions that can be found in other parts of the body. Nevi and moles are common as well as dermatitis, psoriasis and seborrheic keratosis, which occur with age. These dermatologic problems tend to be benign but you should always be concerned about in lesion that changes rapidly, bleeds easily, has irregular borders or are black in color. It is important to see a gynecologist or dermatologist immediately if you have any concerns.

I hope this article has provided you with information that will help you make wise choices, so you may:

Live healthy, live well and live long!