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Lichen planus (LP) is an autoimmune dermatosis of mucosal and cutaneous sites affecting 1% to 2% of the population. It is associated with cancer, especially squamous cell carcinoma (SCC). A 5% risk for SCC is associated with LP of the oral and esophageal mucosa. The risk in vulvar LP is not well documented.
Researchers identified 38 women (median age, 61) with LP-associated SCC. Of these, 25 had nonerosive vulvar LP. The presentation was of skin-colored or white papules or larger, partly hypertrophic plaques with lichenification. Single tumors occurred in 32 patients; 6 had multifocal disease. Lymph node metastasis was present in 16 patients.
On histology, the SCCs were moderately differentiated, focally keratinizing cancers; 30 displayed act…