Abstract

Vulvar lichen sclerosus (LS) is a chronic, inflammatory skin condition that can cause anatomical distortion, dysfunction, and affect quality of life. Vulvar LS shares histopathological findings with other sclerosing disorders such as morphea. CD34-positive dermal dendritic cells are known to be reduced in sclerosing skin disorders including morphea and systemic sclerosis. However, little is known about CD34 expression in vulvar LS. We investigated the expression of dendritic cell markers (CD34, CD123, Factor XIIIa), smooth muscle actin (SMA), and CD68 in vulvar LS compared with peri-lesional or non-LS vulvar pruritus control tissue. Skin biopsies of 29 cases of vulvar LS and 7 vulvar controls were identified. Immunohistochemical stains were collectively analyzed by 3 graders (TF, PK, EK). CD34 expression was characterized as normal, diminished, or absent. There was absent (27/29, 93%) or diminished (2/29, 7%) CD34 in all cases of vulvar LS. In contrast, CD34 staining was normal in 43% (3/7) of vulvar controls. Preliminary data suggests that SMA and CD123 do not significantly differ, while there may be a slight increase in Factor XIIIa and CD68 in lesional skin. Our findings suggest that loss of CD34 may be helpful in identification of vulvar LS. Data from this study may be used to direct further studies on the pathophysiology, diagnosis, and treatment of vulvar LS.