ORIGINAL ARTICLES   

Giornale Italiano di Dermatologia e Venereologia 2002 August;137(4):267-9

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Lichen and vulvar cancer. Personal experience

Rampone A. ¹, Vozza G. ¹, Vozza A. ¹, Rampone B. ², Capuano I. ², Tirabasso S. ², Rampone N. ²

¹ Unità Operativa di Clinica Dermatologica 2 Istituto di Clinica Ostetrica e Ginecologica Servizio di Oncologia Ginecologica Seconda Università degli Studi di Napoli, Napoli

Background. Purpose of our study was to assess how much the presence of p53 mutation in lesions by Lichen Sclerosus (LS) and Lichen Simplex Chronicus (LSC) can influence the neoplastic evolution of these pathologies and, consequently, the therapeutic approach.
Methods. At the Department of Obstetrics and Gynecology of the Second University of Naples (SUN) in collaboration with the Dermosyphilopathic Clinic of the SUN, during the period 1995–1999, we investigated p53 expression in 8 cases of histologically proven vulval LS and in 10 cases of vulval Lichen Simplex Chronicus (LSC) using p53 gene mutation analysis.
Results. There was a significant increase in p53 immunoreactivity in vulval LS compared to vulval LSC. The patients suffering from LSC responded to simple dermatological methods, mainly topical corticosteroids and retinoids, together with LS patients negative at p53 gene mutation analysis (37.5%); while patients suffering from LS with p53 immunoreactivity (62.5%) were subjected to bilateral vulvectomy and lymphoadenectomy. The follow-up, performed so far in all the studied cases, in no case showed neoplastic evolution.
Conclusions. The absence of p53 mutations in vulval lichen, with negative histological examination, allows local pharmacological treatment with good results. Contrarily, once p53 mutation is evidenced, in our opinion, demolition surgical treatment is essential because such condition can generate carcinogenetic mutations.