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Dermatology (Expert Forum)
Lichens Sclerosus vs HPV/Condyloma
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
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Lichens Sclerosus vs HPV/Condyloma
by logansmomma04, Jul 12, 2007 12:00AM
I have a concern I need help with and 2 OB/GYN's have been useless thus far.
2 years I had a vulvar biopsy done of my perineum due to an area that was cracking, bleeding and turning white. It started after my epsiotomy healed the year before, after son was born. Biopsy came back "early stage Lichens Sclerosus." Was given Clob and Test to use.
In this 2 years since biopsy, the biopsied area didn't heal even with the creams. 1st doctor said it wasn't anything but an LS flare-up. Went back for 2nd opinion to another doctor who did another biopsy just last week. He said it appear "wart-like" in nature, seemed to be just inflammation but sent it to pathology.
Results came back today as:
"hyperkeratotic, acanthotic, papillomatous stratified squamous epithelial surface with frequest multinucleated epithelial giant cells and focal koilcytosis. Maturation is minimally delayed. Basal layer is normal. Superficial submucosa is fibrotic with chronic inflammatory infiltrate. DIAGNOSIS: condyloma acuminatum, hyperkeratosis, dysplasia, VIN I."
Concerns:
1 - I thought only HIV positive people developed condyloma. I literally just took a rapid OraSure test yesterday and it was negative. I know I have HPV as I have had paps come back before with it, but have NEVER had a wart in my life!
2 - How can the same, small, pencil eraser sized area go from inflammation to LS to condyloma in 3 years?
3 - Isn't VIN I cancerous?
Please help me
2 years I had a vulvar biopsy done of my perineum due to an area that was cracking, bleeding and turning white. It started after my epsiotomy healed the year before, after son was born. Biopsy came back "early stage Lichens Sclerosus." Was given Clob and Test to use.
In this 2 years since biopsy, the biopsied area didn't heal even with the creams. 1st doctor said it wasn't anything but an LS flare-up. Went back for 2nd opinion to another doctor who did another biopsy just last week. He said it appear "wart-like" in nature, seemed to be just inflammation but sent it to pathology.
Results came back today as:
"hyperkeratotic, acanthotic, papillomatous stratified squamous epithelial surface with frequest multinucleated epithelial giant cells and focal koilcytosis. Maturation is minimally delayed. Basal layer is normal. Superficial submucosa is fibrotic with chronic inflammatory infiltrate. DIAGNOSIS: condyloma acuminatum, hyperkeratosis, dysplasia, VIN I."
Concerns:
1 - I thought only HIV positive people developed condyloma. I literally just took a rapid OraSure test yesterday and it was negative. I know I have HPV as I have had paps come back before with it, but have NEVER had a wart in my life!
2 - How can the same, small, pencil eraser sized area go from inflammation to LS to condyloma in 3 years?
3 - Isn't VIN I cancerous?
Please help me
Doctor's Answer
by Alan Rockoff, MD, Jul 13, 2007 12:00AM
, Jul 13, 2007 12:00AM
HPV is the virus that causes warts. I'm not sure how you know you have HPV, but if you do, then you do have warts. I am far from expert on vulvar biopsies, but it sounds to me as though the second biopsy pretty clearly shows that you have changes associated with HPV that may indeed be pre-cancerous and are treated as such. Didn't the gynecologist who performed the biopsy suggest that you be treated for the findings? I can't imagine otherwise. Your gynecologist, who sounds far from useless, is the one you should be talking to about this. If for some reason you feel you need another opinion, another gynecologist is the one you should seek out. You might also ask that the second pathologist review the slides from the first biopsy, to interpret them in light of the second one.
Good luck.
Dr. Rockoff
Good luck.
Dr. Rockoff
Member Comments (2)
by logansmomma04, Jul 12, 2007 12:00AM
Sorry, the 2nd doc said it DIDN'T appear "wart-like" in nature.
