Vulvar dystrophy: an evaluation of 285 cases.

To determine the effectiveness of medical therapy in vulvar dystrophy, a retrospective, single-institute clinicopathologic study of 285 consecutive cases was carried out. Of the patients, 152 (53.3%) had squamous hyperplasia (SH), 72 (25.3%) had lichen sclerosus (LS), and 61 (21.4%) had lichen sclerosus with areas of squamous hyperplasia (LS + SH). Symptomatic response was 84.8% at 3 months and 92.7% at 6 months in patients with SH. These figures were 70.8% and 87.5% for patients with LS and 68.8% and 80.3% for patients with SH + LS, respectively. Histopathological response was 63.6% at 3 months and 74.8% at 6 months for patients with SH. These figures were approximately 29% and 42% for LS, and 21% and 34% for patients with SH + LS, respectively. Corticosteroids for squamous hyperplasia and testosterone for lichen sclerosus achieved a high symptomatic response. However, histologic remission rates were poorer.