TL;DR:
- Condition: Leukoplakia of the vulva involves white patches on the labia or vaginal outlet, often due to keratin accumulation. It is usually benign but has a small cancer risk.
- Affected Group: Common in postmenopausal women, typically ages 42–53.
- Symptoms: White/gray patches with thickened or hardened skin; often painless and unnoticed. Advanced signs include redness, ulcers, erosions, or discharge, possibly linked to cancer.
- Causes: Chronic irritation, infections (HPV, EBV), venereal diseases, smoking, allergens, hormonal imbalances, UV exposure, or poor hygiene.
- Diagnosis: Physical exam, biopsy, and histopathological studies differentiate it from other conditions like lichen sclerosus.
- Treatment: Varies by severity—ranges from removing irritants to laser therapy, surgery, or topical treatments. Cancerous lesions may require chemotherapy/radiation.
- Prevention: Regular gynecological check-ups are crucial for early detection and management.
Leukoplakia of the vulva is a condition in which specific changes, called white keratosis, occur on the skin of the labia and at the vaginal outlet. It is a type of skin transformation that can be associated with various factors, including chronic mechanical irritation or inflammation. Although leukoplakia is usually a benign lesion, a small percentage of cases may be cancerous. Given the risk of cancer, the unsightly appearance of the labia, and the bothersome symptoms, this disorder is a source of concern for many patients.
What is leukoplakia of the labia majora?
Leukoplakia of the vulva, also known as white keratosis of the vulva, is a precancerous condition that involves the formation of white patches or streaks due to pathological modification of the multilayered squamous epithelium of the external genitalia. It most often occurs around the labia minora and in the area of the vaginal outlet. It usually affects postmenopausal women, with the average age of occurrence ranging from 42 to 53 years. The phenomenon is often accompanied by keratosis of the skin and mucous membrane. The white coloration of the lesion is due to the accumulation of keratin and the lack of vascularization of the area. The keratinized areas themselves rarely hurt or itch, so they are often ignored by patients. Prompt recognition of the condition and taking therapeutic measures make it possible to minimize the development of vulvar cancer, which, although rare, has a rather inauspicious prognosis.
Leukoplakia of the vulva – symptoms.
Symptoms of vulvar leukoplakia include abnormal patches of white or gray color, sometimes also red, with a thick, hard or convex surface. They may occur singly or in larger clusters, often causing hardening and thickening of the skin around the lesion. However, these symptoms are usually not associated with feelings of itching, burning or pain, often causing them to go unnoticed by patients. There is a risk that keratinized foci can develop into malignant vulvar cancer. Early symptoms of cancer can be difficult to spot, but often include redness, papillary hyperplasia of the altered skin, erosions, ulcers, discharge and vaginal bleeding. The aforementioned symptoms may suggest cancerous transformation or inflammation and require careful evaluation by a gynecologist.
Causes of leukoplakia of the labia.
The causes of leukoplakia of the vulva can be varied, although the unequivocal and exact sources are not known. Researchers speculate that chronic skin irritation plays a large role in the development of this condition. Other components that increase the risk of developing labia leukoplakia may include:
- irritating effects of cosmetics, fabric fluids and detergents,
- improper hygiene of the intimate area,
- infections of fungal or bacterial origin,
- venereal diseases,
- infections with human papillomavirus (HPV) and Epstein-Barr virus (EBV),
- cigarette smoking,
- allergies to personal care products or underwear material,
- hormonal changes,
- ultraviolet radiation,
- alcohol abuse.
Diagnosis of leukoplakia of the vulva.
Diagnosis of vulvar leukoplakia usually involves a thorough physical examination by a gynecologist. In some cases, it may be necessary to take skin sections for histopathological examination to confirm the diagnosis and rule out possible cancerous lesions. To rule out other vulvar diseases, such as vulvar intraepithelial neoplasia, candidal mucositis or other neoplastic lesions, a biopsy is necessary. It involves taking a sample of tissue from the affected area of the vulva for careful evaluation under a microscope. This is the only effective method to confirm or exclude the diagnosis of other diseases and determine the possible cancerous nature of the lesions. Thanks to the biopsy, it is possible to accurately determine the type of lesion and choose an appropriate treatment plan, which is key to providing the patient with appropriate medical care. It is important to differentiate the disease from chronic disorders – lichen sclerosus of the vulva, candidiasis of the mucous membranes and vulvar squamous cell hyperplasia, because in the course of these diseases there is also a white coloration of the skin of the external genitalia. The occurrence of these diseases depends largely on factors such as immunity, autoimmune processes, and genetic and environmental components.
Leukoplakia of the labia – how to treat the disorder?
Treatment of vulvar leukoplakia depends on the cause of the disease, the severity of the lesions and, most importantly, the results of the histopathological examination. In some cases, it may be sufficient to remove the irritant, properly moisturize the intimate area or directly treat the infection itself. For more persistent symptoms, other treatments may be used. If the biopsy examination does not reveal cancerous lesions, usually gynecologists suggest anti-inflammatory topical treatment.
Otherwise, lesions that are cancerous in nature should be removed immediately, thereby preventing the spread of pathological cells. Such a treatment is, for example, laser therapy, surgery, cryosurgery or photodynamic therapy. Surgical treatment involves precise excision of lesions using a surgical knife. The electrocoagulation method uses an electric knife to precisely remove lesions. The current heats the tissues and coagulates proteins, leading to the closure of blood vessels and destruction of unwanted cells. Laser methods, carried out under local anesthesia, are also used in the treatment of vulvar leukoplakia. The action of lasers is based on the principle of selective absorption of light by tissues, which leads to thermal damage to target cells. If the cells show the nature of advanced cancerous lesions, chemotherapy or radiation therapy may be necessary.
Preventive measures and additional tests
Probable neoplastic transformation of lesions diagnosed as vulvar leukoplakia may be signaled by the following features:
- papillary hyperplasia of the surface of the keratotic lesion,
- redness surrounding the lesion,
- inflammation,
- erosions appearing on the surface of the lesion,
- ulcerations.
Even after removal of cancerous foci, the risk of developing cancer remains elevated compared to the general population. Therefore, regular visits to the gynecologist are extremely important. Detection and early treatment of leukoplakia significantly improves the prognosis of patients.
Leukoplakia of the vulva – rapid response.
In the case of vulvar leukoplakia, it is important to make an accurate differential diagnosis and implement appropriate treatment to alleviate symptoms and improve the comfort of Patients' lives. Regular check-ups with a specialist are key to monitoring the condition of the vulvar skin and early detection of any pathological changes. If vulvar leukoplakia is suspected, it is important to conduct appropriate diagnostic tests.
Conclusion
Leukoplakia of the vulva, though often benign, demands attention due to its potential cancer risk. Awareness of symptoms, causes, and treatments is crucial for managing this condition. Early diagnosis through physical exams and biopsies increases treatment success, while addressing irritants or infections can reduce complications. Don’t ignore white patches or unusual changes—timely care minimizes cancer likelihood and improves well-being. Regular gynecological check-ups remain vital for spotting and addressing issues early. Stay informed and proactive to safeguard your health effectively.
