Lichen Sclerosus and Other Conditions Mimicking Vulvovaginal Candidiasis

For many women with chronic vulvovaginal symptoms, overdiagnosis of vulvovaginal candiasis (VVC) is an unfortunate tendency. In women with chronic vulvar itching or burning, a vulvar non-neoplastic epithelial disorder is a relatively frequent diagnosis. Although controversy persists about the nomenclature for these disorders, there seems to be a relatively clear consensus with lichen sclerosus. This chronic inflammatory skin disease affects primarily the female vulvar and perianal areas. Left untreated, it may lead to chronic scarring of the vulva with an associated loss of architecture. The etiology remains unknown, although infectious, genetic, and autoimmune causes have been suggested. Most patients will respond to potent topical corticosteroids. Treatment of associated conditions such as atrophic vaginitis or complicated VVC is sometimes necessary. Surgery should be considered in patients with severe scarring.