Hypertrophic Vulvar Dystrophy
Mixed Dystrophy, with both Hypertrophic and Lichen sclerosus
Hypertrophic vulvar dystrophy means the skin of the vulva has grown
thicker than it should be.
Associated with this thickening are the symptoms of intense itching and burning. These
cases present clinically as patients with vulvar itching, initially believed to be
which have failed to respond to standard anti-fungal therapy.
On close inspection, the skin has a patchy white discoloration. A vulvar biopsy
confirms the diagnosis.
Treatment is topical steroids, used to thin the skin and relieve the symptoms.
Vulvar biopsy is very important in these cases since differentiating visually between
Hypertrophic vulvar dystrophy, lichen sclerosus, and
(vulvar intraepithelial neoplasia) is difficult and the treatments are very different.
Further, mixed dystrophies (hypertrophic in some areas, and lichen sclerosus in other
areas.) are common.