Why is a biopsy essential when lichen sclerosus is suspected?
A biopsy is essential because it helps do two important things at once. It confirms whether the skin changes really are lichen sclerosus, and it checks for precancerous or cancerous vulvar changes. In the context we have here at Alloy, experts also point out that menopausal hormone loss can mimic lichen sclerosus, so a biopsy helps avoid the wrong diagnosis.
That matters because untreated lichen sclerosus causes ongoing inflammation, and that inflammation can, in some cases, lead to vulvar cancer. Getting the diagnosis right means treatment can start early and the inflammation can be controlled.
For a clear explanation, this short chapter with Dr. Rachel Rubin is helpful: Lichen sclerosus & vulvar conditions. Our article on vaginal itching and menopause is also useful for understanding how hormone-related dryness and itching can overlap with other vulvar conditions.
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