Year |
Event |
Key reference no.(s) |
1875 |
Weir's report of possible vulvar and/or oral LS as "ichthyosis" |
2 |
1885 |
Breisky describes kraurosis vulvae |
13 |
1887 |
Hallopeau describes series of extragenital LS (and one possible vulvar case) |
1, 3-5 |
1892 |
Darier formally describes classic histopathology of LS |
6, 7 |
1900-present |
Concept that scleroderma and LS are closely related |
72, 73, 222, 227, 231, 290, 358 |
1901 |
Pediatric LS described |
9, 53, 95, 96, 101, 103 |
1913-present |
Concept that scleroderma is not closely related to LS |
45, 145, 148, 158, 238, 240, 281 |
1920 |
Taussig establishes vulvectomy as treatment of choice for kraurosis vulvae, a premalignant condition |
93, 183-185; also 79, 186, 191, 196 |
1927 |
Kyrle defines LS ("white spot disease") as entity sui generis |
359 |
1928 |
Stühmer describes balanitis xerotica obliterans as postcircumcision phenomenon |
14 |
1936 |
Retinoids (vitamin A) used in LS |
47, 195, 341, 349, 352, 353 |
1945 |
Testosterone used in genital LS |
87, 92, 160, 254, 337, 338, 342 |
1961 |
Modern use of corticosteroids |
21, 102, 165, 254, 337, 338, 342 |
1966 |
Jeffcoate presents argument against vulvectomy for simple LS |
119; also 51, 198, 209 |
1971 |
Progesterone used in LS |
254, 338, 344, 345 |
1971 |
Wallace defines clinical factors and epidemiology of LS for all later reports |
21 |
1976 |
Friedrich defines LS as a dystrophic, not atrophic condition; "et atrophicus" dropped |
15 |
1976 |
International Society for Study of Vulvar Disease classification system. "Kraurosis" and "leukoplakia" no longer to be used |
16, 181, 182 |
1980 |
Fluourinated and superpotent steroids used in LS |
54, 56, 96, 101-103, 254 |
1981 |
Studies into HLA serotypes and LS |
44, 217, 273, 275-77, 279 |
1984 |
Etretinate and acetretin used in LS |
25, 149, 343, 354-357 |
1987 |
LS linked with Borrelia infection |
232, 233, 256, 289, 290 |
hr();
head("CLINICAL PRESENTATION");
p("LS can affect all age groups with reported onset from 6 months of age to late adulthood." . sup("21,31,32");?> Most patients described in the literature are Caucasian, but the fact that most studies come out of Great Britain and the United States may create a reporting bias. LS has been reported in native Africans," . sup("33,34");?> Oriental patients," . sup(35);?> and other dark-skinned patients." . sup("36-41");?> The majority are women, but that reflects the intensive study of vulvar "leukoplakia" over the years. The reported female-to-male ranges from nearly 10:1," . sup("42,43");?> to nearer 5:1," . sup("21,44-47");?> to about 1:1." . sup("48,49");?> More cases of purely genital involvement are reported than purely non-genital. However, firm epidemiological data are lacking for many reasons. Gynecologists and urologists do not generally perform a complete cutaneous examination, and dermatologists often exclude a genital examination. Furthermore, an anatomic definition of what constitutes "vulvar" versus "perineal" versus "genital" versus "groin" is lacking." . sup(50);?> " . llink("#Table2">Table II") . " summarizes cases known or suspected to be LS.");
hr();
Sex |
|
|
Female |
4280 |
|
Male |
691 |
|
Unspecified |
236 |
Demographics in metabolic studies often not specified. |
Location |
|
|
Genital |
4308 |
Includes labial, perineal, perianal, and any penile location. |
Extragential |
805 |
Neck, shoulders, upper trunk most common sites reported. |
Both |
355 |
Excludes cases in which site is uncertain. |
Associated Factors |
|
|
Cancer |
283 |
Almost all are SCC of the vulva. Includes unknown number of other vulvar dystrophies. |
Autoimmune disease |
291 |
Not always reported or sought. Thyroid disease, vitiligo, diabetes, and pernicious anemia most common. |
Autoantibodies |
316 |
Not always reported or sought. Thyroid antimicrosomal, gastric parietal cell, and antinuclear autobodies most common. |
p("
1976 terminology* |
1987 terminology† |
Histologic description |
LS |
LS |
Hyperkeratosis, effacement of epidermis, variable interface vacuolization, homogenization and edema of papillary dermis, and lichenoid infiltrate |
Hyperplastic dystrophy without atypia |
Squamous cell hyperplasia |
Hyperkeratosis, acanthosis, epithelial hyperplasia without atypia and not attributable to a more specific dermatosis |
Mixed dystrophy without atypia |
(Report both conditions above) |
Features of LS and hyperplastic dystrophy without atypia |
(no equivalent) |
Other dermatoses |
Typical findings of a specific infectious or inflammatory disease (i.e., psoriasis, condyloma) |
Hyperplastic dystrophy with atypia |
VIN |
Degree of atypia or grade of VIN graded according to degree of squamous proliferation, nuclear atypia and pleomorphism, individual cell keratinization, mitotic activity above the basal layer, and disordered maturation |
Mixed dystrophy with atypia |
(Report both LS and VIN) |
Features of both LS and VIN |
p(" ");
p("