Vulva

Question 1

Compare and contrast histology of lichen sclerosis vs lichen planus

Answer 1

LS:
- lichenoid inflammatory pattern
- atrophic epidermis
- hyperkeratosis
- basal hydropic degeneration
- lymphohystiocytic infiltrate in hyaline band with loss of elastic tissue in upper epidermis
- follicular plugging in hair- bearing skin

LP:
- lichenoid reaction pattern
- irregular saw- toothed acanthosis
- increased granular layer
- basal cell liquefaction
- band- like dermal lymphocytic infiltrate

Question 2

Pathophysiology of LS vs LP

Answer 2

LS:
- inflammatory dermatosis of unknown aetiology
- genetic predisposition

LP:
- autoimmune, mucocutaneous inflammatory disorder
- disorder of altered T- cell mediated immunity to exogenous antigens targeting the basal keratinocytes of the epidermis
- genetic factors

Question 3

Triggers for HSV reactivation

Answer 3

Stress
Menstruation
UV light