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Lichen Sclerosus — SCE Dermatology MCQ

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ModerateGenital DermatologyLichen SclerosusSCE Dermatology

A 35-year-old woman presents with persistent vulval itch. Examination shows white atrophic patches with loss of normal vulval architecture, labial fusion, and burying of the clitoris. What is the approximate lifetime risk of developing vulval SCC in genital lichen sclerosus?

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Correct answer: B — 4-5%

The best answer is “4-5%”. Rapid growth, induration, tenderness, ulceration or other suspicious evolution in a keratotic lesion should prompt assessment for invasive squamous malignancy rather than reliance on a single population risk estimate. The alternatives “Less than 1%”, “30%”, “15-20%”, “50%” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE NG12 suspected skin cancer recommendations: https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#skin-cancers