Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- prurido
- pápulas ou placas violáceas, com a parte superior achatada
- estrias de Wickham
- erosões da mucosa e rede estriada e esbranquiçada
- alopecia cicatricial
- comprometimento ungueal
Outros fatores diagnósticos
- pterígio dorsal
- história de hepatite C (HCV)
Fatores de risco
- hepatite C (em algumas populações de pacientes)
- polimorfismo -308 G/A no gene fator de necrose tumoral (TNF)-alfa
- vacinação contra hepatite B
- vacinação contra gripe (influenza)
- vacinação contra a doença do coronavírus de 2019 (COVID-19)
- estresse psicossocial
- alérgenos orais
- uso de determinados medicamentos
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- diagnóstico clínico
Investigações a serem consideradas
- histopatologia
- rastreamento de hepatite C (HCV)
- imunofluorescência
Algoritmo de tratamento
doença cutânea
doença do couro cabeludo
doença oral
doença genital
doença ungueal
Colaboradores
Autores
Deepani Munidasa, MBBS, MD
Consultant Dermatologist
Department of Dermatology
Anuradhapura Teaching Hospital
Anuradhapura
Sri Lanka
Disclosures
DM declares that she has no competing interests.
Acknowledgements
Dr Deepani Munidasa would like to gratefully acknowledge Dr Susan Cooper, Dr Rebecca Dunn, Dr Julia S. Lehman, Dr Megha M. Tollefson, and Dr Lawrence E. Gibson, previous contributors to this topic.
Disclosures
SC is chair of the British Society for the Study of Vulval Disease and receives royalties for contributions to UpToDate. RD, JSL, MMT, and LEG declare that they have no competing interests.
Peer reviewers
Brian Swick, MD
Clinical Assistant Professor
University of Iowa College of Medicine
Iowa City
IA
Disclosures
BS declares that he has no competing interests.
David Cassarino, MD, PhD
Assistant Professor
Department of Pathology and Laboratory Medicine
University of California
Los Angeles
CA
Disclosures
DC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American College of Obstetricians and Gynecologists. Practice bulletin no. 224: diagnosis and management of vulvar skin disorders. Jul 2020 [internet publication].Full text Abstract
Edwards SK, Bates CM, Lewis F, et al. 2014 UK national guideline on the management of vulval conditions. Int J STD AIDS. 2015 Aug;26(9):611-24. Abstract
Ioannides D, Vakirlis E, Kemeny L, et al. European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol. 2020 Jul;34(7):1403-14.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Líquen simples crônico
- Psoríase
- Líquen plano penfigoide
More DifferentialsGuidelines
- 2021 European guideline for the management of vulval conditions
- British Association of Dermatologists and British Photodermatology Group guidelines for narrowband ultraviolet B phototherapy
More Guidelines
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