A woman aged 40 years presented for a cervical screening test (CST). She was a mother of three and a recently arrived refugee. She had never had a Pap smear or CST in the past because she had been living in a remote area for decades. The purpose of the test was fully explained to the patient. When asked before the procedure about routine symptomatology including menstruation, discharge and itchiness, the patient had no complaints.
During the procedure, in the presence of a chaperone female practice nurse, whitish discolouration of the vulva, involving both labia majora and minora, and clitoris with distorted anatomy was noted (Figure1). On further enquiry, the patient stated she had experienced mild pruritus for several years, and she thought it was due to friction from walking.
Figure 1. Lichen sclerosus of vulva with some anatomical distortion (A = Buried clitoris,
B = Involvement of clitoris hood, C = Distorted labia minora, D = Extending to perineum)
What is the differential diagnosis based on this presentation, and what is the most likely diagnosis?
How will you definitively diagnose this condition?
Given whitish discolouration of the vulva in a woman aged 40 years, the differential diagnosis for this particular case can include:1,2
- lichen sclerosus of the vulva (LSV)
- lichen simplex chronicus
- lichen planus
- post-inflammatory hypopigmentation
- extramammary Paget disease
- vulvar intraepithelial neoplasia (VIN).
The pale-white and ivory-white discolouration of the vulva and clitoris with some anatomical distortion make LSV the most likely diagnosis in this case. If there is a prominent erythematosus with scales, then psoriasis and contact dermatitis can also both be considered as differential diagnoses. Table1 compares and contrasts the features of LSV with other similar conditions.
|Table 1. Differential diagnoses of lichen sclerosus of the vulva9–13|
|Primary lesion features||Main symptom||Genital involvement||Extragenital involvement||Possible dermoscopicfeatures||Histology/microscopy|
|Lichen sclerosus ofthe vulva (LSV)||White patches with sclerotic skin texture, fissures, erosions||Prominent|
|Very common (80%)||Rare|
|White structureless areas with linear vessels, ice slivers, comedo-like openings (hair-bearing area)||Hyalinisation of upper dermis, with a band of lymphocytes below; atrophic or hyperkeratosis epidermis|
|Vitiligo||Well-defined depigmentation with no alteration of skin texture||No itch||Less*||More common*||Homogenous white structureless areas with absent or reduced pigment network||Total absence of functioning melanocytes, with the inflammatory lymphocyte on the edges of the lesions|
|Morphea||Thick, hard skin (sclerotic/fibrosis)||No itch||Rare||More common*||White-yellowish structureless areas, linear vessels within the lilac ring||Atrophic epidermis with increased collagen in the dermis and loss of appendageal structures|
|Lichen planus||Hypertrophic erosions of the vaginal introitus (LSV does not affect vaginal mucosa)||Pain is greater thanitch||Less*||More common*||White crossing streaks (Wickham striae)||Hyperkeratosis and acanthosis; saw-toothing of rete pegs, band-like chronic inflammatory infiltrate obscuring the dermo-epidermal junction|
|Lichen simplex chronicus||Lichenification withscaling||Itch (+++); scratching is pleasurable||Less*||More common*||Scales, exaggerated skin markings||Marked hyperkeratosis associated with foci of parakeratosis, prominent granular cell layer, papillary dermal fibrosis|
|Erythematosus with or without scaling andlichenification||Itch (++)||Common, depending on triggers||Common, depending on triggers||Red dots in a patchy distribution and yellow scales||Extensive spongiosis; initially acute spongiotic dermatitis, evolving into subacute or chronic spongiotic dermatitis|
|Psoriasis||Erythematosus with or without scaling andfissures||Itch (+)||Less*||More common*||Scales and dotted vessels; under high-power imaging, dilated, elongated and convoluted capillaries are visible||Regular acanthosis, confluent parakeratosis, supra-papillary plate thinning|
|Cicatricial pemphigoid||Blisters (bullae) or erosions||Pain||Rare||Mouth||NA||Immunofluorescence analysis – linear deposition of immunoglobulin (Ig) G or IgA, and complement (C3) at the basement membrane zone|
|Vulvovaginal candidiasis||Red, inflamed mucosa with white-curd discharge||Itch (+++)||Common||NA||NA||Confirmation of candidiasis using vaginal swab for microscopy, culture and sensitivities|
|Note: Itch is classified as mild (+), moderate (++) or severe (+++) |
*When compared with LSV
NA, not applicable
A diagnosis of LSV can be made clinically without a mandatory biopsy. However, a punch biopsy from the white sclerotic area is highly recommended to confirm the diagnosis and exclude alternative diagnoses including squamous cell carcinoma (SCC). The histopathology usually illustrates atrophic or hyperkeratotic epidermis with lichenoid infiltrate in the dermal–epidermal junction and the homogenisation of collagen in the upperdermis.2–4
The patient was informed about the unusual discolouration and the possibility of a genital skin disorder. She was scheduled for a biopsy to guide management and rule out SCC. The biopsy confirmed lichen sclerosus with noevidence of neoplasia (Figure2).
Figure 2. Histology and dermoscopy of lichen sclerosus of the vulva (LSV)
A. Histology of LSV; B. Dermoscopy of LSV (A = Structureless white patches [sclerosus], B = Ice sliver, C = Scattered linear vessels mixed with the whitish structure)
What is lichen sclerosus and what are the clinical features of LSV?
What are the aetiology and epidemiology of LSV?
Lichen sclerosus is a chronic inflammatory dermatosis commonly affecting the anogenital region. The condition is characterised by white sclerotic patches that subsequently coalesce, becoming shiny porcelain-white or ivory-white colour. When it affects the vulva, it is called vulvar lichen sclerosus or LSV. It was previously known as lichen sclerosus et atrophicus, kraurosis vulvae, leukoplakic vulvitis and lichen albus. When it affects the penis, the term balanitis xerotica obliterans has been used historically.1,5
Occasionally LSV can be asymptomatic and discovered incidentally during CST.3,6 The possible clinical manifestations of LSV include:
- pruritus (often intractable), pain and bleeding from fissuring and erosion
- dyspareunia and other sexual dysfunction
- constipation and painful defecation if perianal skin is involved
- atrophy and distortion of anatomical structures including burying of the clitoris, fusion or loss of labia minora, stenosis of the introitus, and distortion of urethral orifice resulting in urinary problems.
Morphologically, LSV results in an atrophic or hyperkeratotic surface of the vulva with white sclerotic papules, patches or plaques, which may extend to the perineum and perianal area. Areas of purpura, fissures and erosion can sometimes be seen. Extragenital lichen sclerosus, which predominantly affects the shoulder, neck, thigh, buttock and breast, is seen in 15–20% of cases.2 Figure3 shows various morphologies of genital lichen sclerosus.
Figure 3. Various morphology of lichen sclerosus of the vulva (LSV)
A. LSV with typical shiny porcelain-white vulva (image courtesy of DermNet NZ); B. LSV with erosion and fissures (image courtesy of DermNet NZ)
Dermoscopically, patchy white structureless areas, ice slivers, comedo-like openings (hair bearing area only), purpuric globules and dotted or sparse thin linear vessels can be seen (Figure2).3
Lichen sclerosus can be associated with autoimmune-related diseases such as thyroid disease, vitiligo, alopecia areata and pernicious anaemia.2,7
The exact aetiology of lichen sclerosus remains speculative. Several theories such as autoimmune (approximately 20% association), genetics (12% positive family history), hormonal factors and chronic trauma/irritation have been proposed.1,7,8 LSV commonly affects individuals from the fifth decade onwards but can be seen at any age including prepuberty. Approximately 30–50% of affected women develop symptoms prior to menopause.6,9 The prevalence of LSV is estimated to be one in 30 older women and one in 900 prepubertal girls.1 Most scholars suggest that genital lichen sclerosus is underreported because of a number of factors: lack of awareness of the patient and practitioner; embarrassment and reluctance to disclose symptoms; and presentation at different practitioners of general practice, sexual health, gynaecology, urology and dermatology.1,3,6 As a result, delays in diagnosis and undertreatment are not uncommon. Although earlier literature reported that lichen sclerosus and LSV generally affect individuals of Caucasian descent, the condition can be seen in patients of any ethnicity.1
The patient underwent a blood test for autoantibody screening, and the results showed no associated autoimmune disorders; such investigation is not routinely required for every case. She had no other skin disorders. She was referred to a dermatology clinic at public hospital. While waiting to be seen by a specialist, the patient was treated with potent topical corticosteroid (TCS; mometasone furoate 0.1% ointment) with general advice as per current guidelines. She had some improvement in symptoms and skin texture within six weeks.
What are the complications of LSV?
What are the management options for LSV?
The complications of LSV are:
- anatomical distortion/alteration – as described in the clinical manifestations, resulting in sexual dysfunction plus urinary and bowel opening problems
- psychological – LSV significantly affects the individual’s sexual function and quality of life, resulting in psychological distress and low self-esteem
- cancer – there is an increased risk of vulvar SCC of approximately 5%.1,2
Goals of treatment are to: 1) alleviate symptoms of pruritus, fissuring and pain, 2) improve sexual function and quality of life and 3) reduce scarring (structural distortion) and risk of cancer.8 The detailed management for LSV is outlined as follows.
Ultra-potent or potent TCSs are the first line of treatment. They provide both symptomatic relief and clinical improvement, reducing complications of scarring and malignant change.3,4,9 TCSs (one fingertip unit = 0.5 g) are applied twice daily until symptoms (itchiness, soreness) are relieved (1–2weeks), then reduced to daily application until the return of normal texture of the skin (usually 1–2 months), and later on alternative days, totalling approximately three months from the start of treatment. Afterward, maintenance treatment using lower potency (mid-strength) TCSs such as betamethasone valerate (0.02%), triamcinolone acetonide (0.02%) or methylprednisolone aceponate (0.1%) twice weekly is generally recommended. Frequency of TCS application can be individualised depending on hyperkeratosis. Ointment-based TCSs are commonly preferred to cream in genital areas because of better absorption as well as barrier function.6,9 TCS therapy is safe and inexpensive to use, and it is effective in 90% of patients.10
It is advisable to review the patient in 4–6 weeks and three months from the start of TCS therapy. A 6–12-monthly follow-up is recommended during maintenance treatment. Treatment failure at any stage indicates the need to consider an incorrect diagnosis, noncompliance issue, development of VIN or SCC, or superimposed factors such as allergic reaction to specific medications, infection (candida, virus [herpes simplex virus], bacteria [Staphylococcus spp., Gardnerella spp.]), and irritation from excess sweat orurinary and faecal incontinence. Thereis no role for topical testosterone andoestrogen.
General measures include the following:
- Counsel patients about the nature of disease, course, treatment and need for follow-up. Some individuals may need reassurance that lichen sclerosus is not a sexually transmissible infection.
- Advise patients to avoid scratching and irritants to the genital area by using soap substitutes for cleaning and applying a protective barrier (eg soft paraffin or emollient) to minimise the contact with sweat, urine and faeces. Other vulvar irritants may include hygiene products, creams, lubricants, contraceptives and procedures (eg improper hair removal). Tight underwear and any activities that can rub onto the sensitive mucosa (egriding a bicycle or horse) should also be avoided.10,11
- Advise patients to become familiar with the appearance of their genital area, as lifelong monitoring is required to detect, diagnose and treat new lesions or scarring.
Consider multidisciplinary care involving a local vulvar clinic (if available) or dermatologist or gynaecologist with an interest in lichen sclerosus. For example, surgery for correction of anatomical distortion or treatment of early carcinoma may be needed.
Discussion and conclusion
General practitioners (GPs) have an opportunity to detect genital skin lesions while performing a CST. It is prudent for GPs to be familiar with characteristic features of genital skin disorders to be effectively able to carry out further actions. Early detection and treatment with timely referral for genital skin disorders such as LSV will reduce the impact on the patient’s morbidity both physically and mentally. Management of vulvar skin disorders spans dermatology, gynaecology and sexual health, and referral to a pertinent specialist is recommended depending on the severity and complication of the disease. The prognosis of LSV is usually favourable if diagnosed and treated in the early nonscarring stages.
- Genital skin disorders are generally underreported because of various factors.
- GPs have an opportunity to detect genital skin lesions while performing a CST or investigating a patient’s direct concerns.
- Early detection and treatment for genital skin disorders such as LSV will reduce the impact on the patient’s morbidity physically and psychologically.
Competing interests: None.
Provenance and peer review: Not commissioned, externally peer reviewed.
Correspondence to: email@example.com
Lichen sclerosus (LIE-kun skluh-ROW-sus) is a condition that causes patchy, discolored, thin skin. It usually affects the genital and anal areas. Anyone can get lichen sclerosus but postmenopausal women are at higher risk. It isn't contagious and can't be spread through sexual contact.What do lichen sclerosus lesions look like? ›
The lesions caused by lichen sclerosus usually begin as small, pinkish or whitish bumps. Over time, they become patchy, wrinkly and white, often resembling tissue paper. These patches tend to be itchy and painful. Because the affected skin is delicate, even light itching may cause bleeding.Does genital lichen sclerosus go away? ›
With treatment, symptoms often improve or go away. Treatment for lichen sclerosus depends on how severe your symptoms are and where it is on your body. Treatment can help ease itching, improve how your skin looks and decrease the risk of scarring. Even with successful treatment, the symptoms often come back.How did I get lichen sclerosus? ›
The cause of lichen sclerosus (LS) is not clear; health care providers suspect that a number of factors may be involved. Genetic factors — LS seems to be more common in some families. People who are genetically predisposed to LS may develop symptoms after experiencing trauma, injury, or sexual abuse.When does lichen sclerosus turn cancerous? ›
In some cases, lichen sclerosus can lead to cancer, but only 4% of women with the condition have been reported to develop vulvar cancer. This can take many years, so it is believed that with proper treatment and frequent visits to a doctor, cancer can be avoided.Can genital warts look like white spots? ›
Genital warts are small, flesh-colored, grayish white or pinkish white growths. You may have many warts or just 1 wart. The warts usually appear as thin, flexible, solid bumps on the skin that look like small pieces of cauliflower. Some warts, however, are quite small and flat and may not be easily noticed.Is lichen sclerosus an STD? ›
Like many non-contagious conditions, lichen sclerosus shares some symptoms with sexually transmitted diseases (STDs), but it is not a disease that can be contracted from touching surfaces or through sexual contact. You don't have to worry about spreading lichen sclerosus to your sexual partner.Is lichen sclerosus cancerous? ›
Vulval lichen sclerosus (LS) is a non-cancerous skin condition of the vulva.What do vulvar cancers look like? ›
Invasive squamous cell cancer of the vulva
These can include: An area on the vulva that looks different from normal – it could be lighter or darker than the normal skin around it, or look red or pink. A bump or lump, which could be red, pink, or white and could have a wart-like or raw surface or feel rough or thick.
Typical lesions of lichen sclerosus are porcelain-white papules and plaques, often seen in conjunction with areas of ecchymosis or purpura. The skin typically appears whitened, thinned and crinkling ('cigarette paper' in appearance).
Oxidative stress (OS) has been proven to play a role not only in the pathogenesis of LS, but also in the development and progression of the disease. OS, by causing DNA damage and lipid peroxidation, contributes directly to the possible malignant transformation of LS.What can lichen sclerosus be mistaken for? ›
Lichen sclerosus is often mistaken for thrush so see your doctor if you are often itchy in the vulvar or anal area. There are treatments that can help you successfully manage the symptoms.Can poor hygiene cause lichen sclerosus? ›
LS is not contagious and cannot be transmitted by sexual intercourse. It is also not caused by poor hygiene. There is some speculation, as yet unproven, that LS may be inherited.What happens if you don't treat lichen sclerosus? ›
Scarring: Untreated, lichen sclerosus can lead to scarring around your vulva, and your clitoral hood may look flat – so that your anatomy looks different. There may be scarring on your anus or penis. Scarring can cause problems peeing or pooping (constipation), and it can lead to painful sex (dyspareunia).What should I wash with if I have lichen sclerosus? ›
Self-help for lichen sclerosus
Avoid washing with soap or bubble bath – use plain water or an emollient wash instead, such as aqueous cream (but avoid leaving aqueous cream on the skin after washing) Avoid rubbing or scratching the area.
Seventy-five percent of sexually active people acquire HPV during their lifetime, thus HPV alone is not a cause of LS. Genetic and immunological host factors and viral factors other than type are likely to contribute.What does vulvar lichen sclerosus look like? ›
Lichen sclerosus appears as white areas of skin that often are shiny or wrinkled. Sometimes these white areas have red or pink changes. In patients with a darker skin tone, LS may initially look like vitiligo (a condition in which the skin loses its pigment, causing white patches).Is vulvar lichen sclerosus serious? ›
Vulvar lichen sclerosus may slightly increase the risk of squamous cell skin cancer in women. Men with lichen sclerosus on the penis may also have an increased risk. (Lichen sclerosus on other parts of your body does not seem to increase your cancer risk.)Does HPV cause white bumps? ›
But when HPV does not go away, it can cause health problems like genital warts and cancer. Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower.What do non STD warts look like? ›
Genital warts look like skin-colored or whitish bumps that show up on your vulva, vagina, cervix, penis, scrotum, or anus. They kind of look like little pieces of cauliflower. You can have just one wart or a bunch of them, and they can be big or small. They might be itchy, but most of the time they don't hurt.
Most commonly, genital warts appear clustered as a few small, raised lesions, but their appearance varies. They can be flesh-colored, light and pearly, or dark purple, gray, or brown. There may be many or only one. They may be small and difficult to see or they may enlarge and combine into masses.What causes lichen sclerosus flare? ›
What can aggravate lichen sclerosus? Irritants such as soap, detergents, shower gels and bubble baths can aggravate lichen sclerosus, so using these irritants should be avoided. Friction or damage to the skin can make it worse so overzealous washing and drying of the vaginal or anal area should be avoided.Is lichen sclerosus a hormone imbalance? ›
Research suggests that an overactive immune system and/or unbalanced hormones play a role in causing lichen sclerosus. It may also be a genetic condition, so your chances for developing the condition are higher if your mother or other female relatives experienced it as well.Can a gynecologist treat lichen sclerosus? ›
The team at The Ob-Gyn Center have extensive experience using the MonaLisa Touch to effectively treat lichen sclerosus and lichen planus. Using a specially designed applicator that's shaped to treat both sides of the vulva, the fractional CO2 laser sends tiny beams of energy into the vulvar tissues.Is lichen sclerosus a fungus? ›
Is Lichen Sclerosus a Fungal Infection? The pain, itching and patchiness of lichen sclerosus may be similar to symptoms of a fungal skin infection, but so far research has not linked the condition to a fungus, virus or bacteria.Can you live with lichen sclerosus? ›
Living with lichen sclerosus
Lichen sclerosus often can be managed with treatment. If left untreated, the conditions can have serious effects. Severe cases may cause severe pain during sex. You may be emotional about having a condition in your genital area.
Skin lesions are mainly typical of those found elsewhere on the body, and are found on the outer aspects of the vulva, the labia majora, extending to the groin. They include benign (harmless) and malignant (cancerous) tumours. They are often classified according to cell of origin. Viral infections may mimic lesions.Are all vulvar lesions cancerous? ›
Most instances of vulvar intraepithelial neoplasia will never develop into cancer, but a small number do go on to become invasive vulvar cancer. For this reason, your doctor may recommend treatment to remove the area of abnormal cells and periodic follow-up checks.What can be mistaken for vulvar melanoma? ›
Paget's disease vs.
Other lesions that can be confused with melanomas of the vulva include Paget's disease and dysplastic nevi.
|Disease||Overall (n = 532) n (%)||p-value (females vs. males)|
|Autoimmune thyroid diseasea||65 (12.2)||0.0002|
|Rheumatoid arthritis||4 (0.8)||1|
|Localized scleroderma||9 (1.7)||0.12|
|Ulcerative colitis||1 (0.2)||0.3|
The main difference between the two conditions is that LP has a propensity to involve the mucous membranes including the mouth and vagina which are rarely affected in LS. First-line treatment for LS is a super-potent topical corticosteroid ointment which has a high response rate.What is it like living with lichen sclerosus? ›
VLS causes intense itching and painful tears in the vulval skin, and can result in architectural changes such as narrowing of the vaginal entrance and burying of the clitoris . It is also associated with an increased risk of vulval cancer, with up to 60% of vulval cancers occurring on a background of VLS .Is Vaseline good for lichen sclerosus? ›
How is Lichen Sclerosus treated? Treatment includes vulval care (avoiding soaps and using cotton underwear), lubricants (Vaseline), estrogen cream, topical steroids, and other medical treatments.What vitamins should I take for lichen sclerosus? ›
Conclusion: Once VLS has been stabilized with topical corticosteroids, long-term treatment with both vitamin E and emollients may be considered in maintain LS remission.What foods affect lichen sclerosus? ›
Foods to avoid for lichen sclerosis
- spinach, raw and cooked.
- canned pineapple.
- many boxed cereals.
- dried fruit.
- rice bran.
- bran flakes.
- soy flour.
Anogenital itching and clinical features such as erythema, white skin changes (such as hyperkeratosis and sclerosis), and fissures should arouse suspicion of lichen sclerosus. The diagnosis should be confirmed with a skin biopsy, and early, thorough treatment should be initiated.Is there a blood test for lichen sclerosus? ›
Your health care provider may do blood tests to check for autoimmune diseases. It can be made worse by skin irritation, like scratching, and any infection on open skin from yeast or bacteria. Lichen sclerosus is not an infection and is not contagious.Is lichen sclerosus a progressive disease? ›
Lichen sclerosus (LS) is a benign, chronic, progressive dermatologic condition characterized by marked inflammation, epithelial thinning, and distinctive dermal changes accompanied by symptoms of pruritus and pain (picture 1A-C) .Is lichen sclerosus related to thyroid? ›
It can be associated with other diseases in which the body's immune system attacks normal tissues such as the thyroid gland (causing an overactive – or underactive thyroid gland) or the insulin-producing cells in the pancreas (causing diabetes), but it has not been proven that it is an auto-immune condition in itself.Is lichen sclerosus caused by low estrogen? ›
In addition, LS seems to be associated with a low-estrogen state: Women are at most risk of developing the condition before puberty or during perimenopause and menopause.
Approach to vulvar lichen sclerosus natural treatment
Rehmannia and Baical Skullcap are useful herbs in this regard; Certain herbs including Chickweed and Calendula reduce itching, pain and skin inflammation. A naturopath can add these to a vitamin E cream for you to apply to the area to relieve your symptoms.
Initial treatment usually requires daily application of the ointment for one to three months to resolve the symptoms and reduce inflammation.How does lichen sclerosus affect urination? ›
Patients with vulvar lichen sclerosus may also have bladder, pain, and bowel comorbidities. Bladder comorbidities that were self-reported more frequently among patients with vulvar lichen sclerosus than in the general population include urinary incontinence and stress urinary incontinence.Can you reverse the damage of lichen sclerosus? ›
Although there's no cure for lichen sclerosus, there are treatments that can help. If you have it on your genitals, you should get it treated, even if you don't have symptoms. When left untreated, it can lead to problems with sex or urination. Patches on other parts of the body usually go away with time.How do you treat vitiligo on the genital area? ›
- Medications. Topical creams and ointments may help to reduce the appearance of vitiligo. ...
- Light therapy. Using ultraviolet A, ultraviolet B, or excimer light to help restore pigment to the skin of your penis may be effective. ...
If thick, white discharge goes along with other symptoms, such as itching, burning and irritation, it is probably due to a yeast infection. If not, it is normal discharge. You may also notice an increase in thick, white discharge before and after your period.What does white yeast infection look like? ›
a thick, white discharge that can look like cottage cheese and is usually odorless, although it might smell like bread or yeast. pain or burning when urinating (peeing) or during sex.What are the types of white patches? ›
- Milia. Milia develops when keratin gets trapped under the skin. ...
- Pityriasis alba. Pityriasis alba is a type of eczema that causes a flaky, oval patch of discolored white skin to appear. ...
- Vitiligo. Vitiligo is a skin disorder caused by loss of pigmentation. ...
- Tinea versicolor. ...
- Idiopathic guttate hypomelanosis (sun spots)
Topical steroids come as a cream or ointment you apply to your skin. They can sometimes stop the spread of the white patches and may restore some of your original skin colour. A topical steroid may be prescribed to adults if: you have non-segmental vitiligo on less than 10% of your body.What is the best medicine for white spot? ›
- low-dose corticosteroid creams, like 1-percent hydrocortisone cream.
- Elidel cream, a nonsteroidal formula.
- ultraviolet light treatment in combination with topical medications.
- bleaching the skin surrounding large white patches to blend them.
- tattooing over white patches.
Male genital vitiligo is relatively frequent and often induces marked impairment of quality of life, with a specific impact on sex life. Prompt recognition of activity remains mandatory to halt disease progression, as repigmentation remains difficult to achieve in most cases.Can you have vitiligo only on genital area? ›
For example, vitiligo can affect a small area (usually early on before it spreads), called focal vitiligo. It can become widespread, often called generalized vitiligo. It can affect just the lips and genitals, called mucosal vitiligo, or those areas plus the fingertips, called lip-tip vitiligo.Is vitiligo an STI? ›
It is very important to note that vitiligo is not a sexually transmitted infection (STI). It can't be spread by skin-to-skin contact, and you can't catch it from someone else. It is most likely an autoimmune condition and isn't triggered by a bacterial or viral infection.Can Stds be white? ›
Chlamydia or Gonorrhea
While yeast infections produce thick, white, cottage-cheese like discharge, Chlamydia can cause white, green or yellow discharge. Gonorrhea discharge is white or green.
- Bacterial vaginosis (BV) ...
- Cytolytic Vaginosis (CV) ...
- Allergic reaction (contact dermatitis) ...
- Genital herpes. ...
- Genital warts. ...
- Trichomoniasis ("trich") ...
- Gonorrhea ...
With yeast infections, discharge is usually thick, white, and odorless. You may also have a white coating in and around your vagina. With bacterial vaginosis, you may have vaginal discharge that's grayish, foamy, and smells fishy. (But it's also common for BV to have no symptoms.)Are yeast infection bumps white? ›
Oral thrush is a type of yeast infection that affects the mouth and tongue area. Thrush is common in young children, elderly people, and those who take antibiotics or steroids. Thrush sores typically appear as velvety white sores in the mouth and on the tongue.