Vulvar leukoplakia

　　The main causes of vulvar leukoplakia include the following points:

　　1. Vulvar infection and inflammation: This is the main cause of vulvar leukoplakia, with about 50% of patients developing from this cause. There are many factors that can cause vulvar infection and inflammation, such as poor hygiene habits, wearing synthetic underwear, unclean sanitary products, bathing in public pools, swimming in bathhouses, etc., which can lead to vaginal inflammation. If it is not treated in time, the inflammatory secretion will infiltrate the perineum, causing long-term infection and stimulation, which will damage the skin and mucosa, leading to redness, ulcers, and deformation, and gradually developing into vulvar leukoplakia.

　　2. Endocrine disorders: Endocrine disorders are caused by pathological changes in endocrine glands and tissues, or due to reasons such as genetics, enzyme defects, and immune function, leading to endocrine disorders and endocrine diseases. Through the measurement of tritium (h3) labeled thymine, it is believed that there is a protein hormone in the dermis that can inhibit the division and growth of epidermal cells, which only acts locally on the epidermis and has tissue specificity. This hormone is called inhibitor, which causes a disorder between the proliferation of local connective tissue and the stimulation of the epidermal metabolism at that site, leading to vulvar leukoplakia.

　　3. Genetic factors: About 10-30% of patients with vulvar leukoplakia are caused by genetics. The leukoplakia caused by genetics is mainly萎缩型, with young girls as the main patients. In clinical practice, attention should be paid to the genetic factor for patients under 15 years old, and inquire whether there are patients with vulvar leukoplakia in their parents' families.

　　4. Other diseases: Conditions such as diabetes, vitiligo, vulvar eczema, and vulvar itching may also lead to or exacerbate the formation and development of leukoplakia if drugs are used improperly or treatment is not appropriate.

　　There are many causes of vulvar leukoplakia, but the main cause is still infection and inflammation of the vulva. Therefore, women should pay more attention to their daily life to reduce infections and the occurrence of vaginal inflammation. This requires starting from aspects such as hygiene and diet.

　　People should not ignore the existence of vulvar leukoplakia in their daily lives. Pay attention to the treatment methods when suffering from vulvar leukoplakia, and there are many preventive methods for vulvar leukoplakia. The main complications of vulvar leukoplakia are as follows:

　　1. Vulvar lichen sclerosis: It is a common complication of vulvar leukoplakia, mainly manifested as the atrophy of the skin in the vulva and perianal area, and the skin gradually becomes thinner, causing a disease that causes the body's immune function to be disordered due to a disorder of the body's immune function.

　　2. Diabetes: Some patients with vulvar leukoplakia may develop diabetes. The influence of both is mutual. The gradual worsening of vulvar leukoplakia can lead to disordered endocrine function in the body.

　　3. Malignant cycle of skin lesions: It is a serious complication of vulvar leukoplakia. The skin itching symptoms in the patient's genital area are difficult to bear. If the condition does not improve for a long time, scratching the local area may cause further skin damage, leading to local bleeding, purulent discharge, and other conditions, which seriously affects the treatment effect.

　　4. Irregular menstruation combined with vulvar leukoplakia: Both are related to endocrine disorders. Once diagnosed in clinical practice, treatment is required.

　　Severe vulvar itching is the main symptom, and the duration of itching from onset to treatment is between 2 to 3 months, and some may last up to 20 years. The intensity of itching does not change with the seasons or day and night. If accompanied by trichomonal or candidal vaginitis, there will be more discharge, and the skin and mucosal damage or infection related to burning sensation, pricking, and itching may be related. There are varying degrees of pigmentation reduction in the local skin and mucosa, with frequent edema, fissures, and scattered superficial ulcers.

　　One, hyperplastic malnutrition

　　It usually occurs in women aged 30 to 60. The main symptoms are severe vulvar itching that is difficult to bear, and the pain increases after scratching. The range of lesions varies, mainly affecting the labia majora, interlabial groove, prepuce of the clitoris, and posterior symphysis, often showing symmetry. The skin of the lesions thickens like leather, with wrinkles, or with scales or eczema-like changes. The surface color is often dark red or pink, with clear white spots, generally without atrophy or adhesion.

　　Two, sclerotic lichenoid malnutrition

　　It can occur at any age, most common in women around 40 years old. The main symptoms are itching in the lesion area, but they are generally much lighter than hyperplastic lesions, and sexual intercourse difficulties appear in the late stage. The lesions involve the vulvar skin, mucosa, and perianal skin. In addition to the whitening, thinning, and dryness of the skin or mucosa, they also lose elasticity. The clitoris often atrophies and is adhered to the prepuce, and the labia minora become flat and disappear. In the late stage, the skin becomes thin and皱缩 like cigarette paper, the vaginal orifice becomes narrow and contracted, and only the tip of the finger can enter.

　　Young girls suffering from this disease often feel discomfort in the vulva and perianal area after urination or defecation, with the appearance of lock hole-like yellowish or white lesions in the vulva and perianal area. Generally, by the time of puberty, the lesions often disappear spontaneously.

　　Three, mixed malnutrition

　　It mainly manifests as the adjacent areas of the thin vulvar whitening area, or there are focal skin thickening or protrusion within the range.

　　Vulvar leukoplakia is a stubborn gynecological disease that requires a long time to cure, and this disease is very hereditary, or there is a possibility of heredity. The main methods of preventing vulvar leukoplakia are:

　　One, Because women's vulva has self-cleaning function, generally wash 2-3 times a week is enough, do not use any detergent (because it is generally alkaline) when washing, just use warm water to wash.

　　Two, Pay attention to the combination of work and rest, avoid overwork, excessive mental tension, and all kinds of mental stimulation.

　　Three, In order to prevent vulvar leukoplakia, women also need to treat diabetes, pinworms, and vulvar, vaginal trichomoniasis or fungal infections. Treat all diseases that increase vaginal discharge, such as vaginitis, pelvic inflammation, and cervicitis, to avoid the vulva frequently being soaked with vaginal discharge and causing inflammation.

　　Four, Wear loose cotton underwear, do not wear nylon or synthetic products. In summer, when it is hot and sweating, it is not suitable to wear tights, and it is not suitable to wear tight pants or jeans in daily life.

　　Five, Eat more vitamin-rich foods, correct anemia, low gastric acid, and all abnormal eating habits.

　　Six, On the one hand, through exercise, it can enhance the body's immunity, and on the other hand, it can regulate the body's own endocrine and promote blood circulation. Often, it is necessary to exercise regularly and do a good job in the prevention of vulvar leukoplakia.

　　Seven, Pay attention to the regulation of life stress and emotions, maintain an optimistic mood, and be cheerful. In this regard, the family members of the patients should actively cooperate to help them build confidence in overcoming the disease.

　　Eight, Try to eat less or not at all fatty, fried, moldy, salted, smoked, alcoholic, and spicy刺激性 foods.

　　Nine, Do not overwork yourself, ensure sufficient sleep, adjust your mood, and enhance your immunity. Vulvar and vaginal inflammation should be treated promptly to eliminate external factors that may cause lesions.

　　Vulvar leukoplakia needs to be diagnosed with the following examinations:

　　Five, Electronic Vaginal Microscopy Examination: This method for examining vulvar leukoplakia is to use electronic vaginal microscopy to observe cervical lesions, which is obviously much easier to detect cervical leukoplakia than with the naked eye. According to local inspection, iodine test for vulvar leukoplakia, and colposcopy, diagnosis is generally not difficult. But more importantly, after the leukoplakia is discovered, further examination should be carried out to avoid missing early cervical cancer changes coexisting with the leukoplakia.

　　Four, Auxiliary Examination: Multiple biopsies are sent for pathological examination to determine the nature of the lesion and exclude early cancer changes. Vulvar leukoplakia usually has two examination methods: first, routine gynecological examination. Second, laboratory examination of vaginal secretions.

　　Three, Vulvar Biopsy: It is one of the main examination methods, with accurate and reliable results, and the report can generally be made within 20 minutes.

　　Four, Vaginal Discharge Examination: The examination items include pH value, cleanliness, ammonia test, and other 6 items. It should be noted that the physical condition of the patient can affect the accuracy of the examination. Attention should be paid to avoid vulvar leukoplakia examination when there are these conditions. Prostatitis and menstrual periods are prohibited from examination.

　　Five, Iodine Test: The principle of this method for examining vulvar leukoplakia is due to the lack of storage ability of glycogen due to epidermal keratinization or incomplete keratinization. The iodine solution does not stain locally, thereby enabling the detection of the extent of the lesion. However, the iodine test is non-specific, and positive results can also be seen in conditions such as cervical erosion, inversion, or precancerous lesions.

　　6. Local examination: By carefully observing the local cervix, white plaque areas can be found, but incomplete keratosis lesions cannot be distinguished with the naked eye, which is also one of the examination methods for vulvar leukoplakia.

　　Foods that vulvar leukoplakia patients should eat include:

　　⑴ Eat more foods that have an anti-vulvar tumor and leukoplakia effect, such as sesame, almonds, wheat, barley, loofah, black chicken, cuttlefish, green mamba, pork pancreas, chrysanthemum, black plum, peach, lychee, horse齿苋, chicken blood, eel, abalone, crab, horseshoe crab, sardine, clam, tortoise shell, etc.

　　⑵ To relieve pain, eat horseshoe crab, red, lobster, clam, sea cucumber, tiger fish, beetroot, mung bean, radish, chicken blood, etc.

　　⑶ To relieve itching, eat amaranth, cabbage, turnip, taro, kelp, nori, chicken blood, snake meat, pangolin, etc.

　　⑷ To enhance physical fitness and prevent metastasis, eat silver ear, black fungus, mushrooms, monkey head mushrooms, gizzard, sea cucumber, Job's tears, walnuts, crabs, lizard, needlefish, etc.

　　Foods that vulvar leukoplakia patients should not eat include:

　　⑴ Avoid smoking, alcohol, and spicy刺激性 foods.

　　⑵ Avoid greasy, fried, moldy, and preserved foods.

　　⑶ Avoid foods that cause heat, such as rooster and goose.

　　⑷ Avoid seafood and刺激性, allergenic foods when itching is severe.

　　⑸ Avoid hot and spicy foods such as mutton, chives, ginger, pepper, cinnamon, etc. if there are ulcers and bleeding.

　　Vulvar leukoplakia refers to localized or diffused white plaques on the skin of the female genital area, which can spread to the inner side of the lower limbs, perineum, and anus, but rarely invades the urethral orifice and vestibule. The clinical characteristics of this disease are: severe vulvar itching, sometimes with burning and pain. The skin of the affected area is rough, shows thickening of lichenoid, has scratch marks, and sometimes occurs fissures, ulcers, etc. It directly affects urination and sexual life, and the degree of suffering is hard to describe. The traditional treatment methods for this disease are as follows:

　　1. Drug Treatment: After cleaning the vulva with a Ph4 weak acid formula feminine care liquid, apply hormone drugs locally, inject anaerobic bacteria locally, and use traditional Chinese medicine treatment, etc.

　　2. Physical Therapy: Microwave therapy, carbon dioxide laser and helium-neon laser, Bome light, high-frequency electrosurgery, local electrocautery treatment, and local cryotherapy with liquid nitrogen, etc.

　　3. Surgical Treatment: Simple vulvectomy, vulvectomy with skin grafting.