chronic inflammatory condition that typically occurs in postmenopausal women

| Clinical features | • Women age 50-60 • Vulvar pain or pruritus • Dyspareunia • Erosive variant (most common): ◦ Erosive, glazed lesions with white border ◦ Vaginal involvement ± stenosis ◦ Associated oral ulcers • Papulosquamous variant: ◦ Small pruritic papules with purple hue | | --- | --- | | Diagnosis | May be made clinically but should be confirmed with a vulvar punch biopsy because the clinical features of lichen planus may overlap with those of vulvar cancer.  | | Treatment | High-potency topical corticosteroids |

<aside> 💡 require evaluation of all mucosal surfaces because erosions may occur in the absence of other symptoms

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<aside> 💡 (Choice C)  Lichen sclerosus can present with vulvar pruritus and white vulvar plaques with associated erosions.  However, patients with lichen sclerosus typically have no vaginal involvement, making the diagnosis unlikely in this patient with an erythematous vaginal epithelium and serosanguinous vaginal discharge.

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(Choice D)  Vulvovaginal atrophy may present with vulvar pain and serosanguinous discharge; however, there is no association with either oral lesions or erosive vulvar lesions.