Multiple areas may need biopsy. The risk for progression to cancer is actually low for VIN, particularly in younger patients, but treatment is still necessary prevent patients from disease progression. These lesions may be covered by a nonadherent, oily scale. Pruritus and the finding of similar extraovular lesions increases suspicion, and biopsy make the diagnosis. Seborrheic dermatitis may mimic chronic candida, psoriasis, contact dermatitis, and, if focal, VIN, although this is usually a generalized disorder of the vulva.
Treatment consists of topical steroids.
There is a familial tendency. Vulvar disease is manifested by red or red-yellow papules in intertriginous areas, with scales that produce pinpoint bleeding when removed. These lesions may enlarge to form focal, red plaques. This condition may mimic candidiasis. Lichen planus can by an intensely pruritic and painful condition that may be an autoimmune phenomenon.