Labial Adhesion Secondary to Lichen Sclerosus Masked by Vulvar Hailey-Hailey Disease

Labial adhesions in postmenopausal women are caused by various inflammatory processes in the context of estrogen deficiency. Lichen sclerosus (LS) is a chronic, progressive condition characterized by idiopathic epithelial thinning of the anogenital region with symptoms of significant pruritus, discomfort, and dyspareunia. Early diagnosis and treatment of LS can prevent disease progression, leading to labial adhesions and malignancy. We present an 84-year-old woman with long-standing vulvar Hailey-Hailey disease who developed labial adhesions. Clinical examination with vulvar biopsy revealed histopathological findings consistent with LS. Surgical separation of the labia by blunt dissection was then performed, and clobetasol ointment and vaginal dilatators were postoperatively prescribed. This resulted in a significant improvement in her symptoms. This is the first reported case of LS in a patient with Hailey-Hailey disease.