Carcinogenesis in vulvar LP
No cases of d-VIN were identified in our series. Usually, the malignancy precursor associated to vulvar dermatosis is d-VIN, a more rapidly progressing precursor and not related to HPV.4However, concordant with our findings are the ones published by Regauer S, et al and Preti M, et al that reported cases of LP which developed HPV-dependent vulvar SIL lesions.4,5They both present the theory of immunosuppression caused either by the topical treatments frequently used for this disease and the immunosuppression status that many of these patients have because of the association with autoimmune diseases, as the most probable cause for HPV-related lesions. This immunosuppression can cause a reactivation of a previous undetectable HPV or facilitate the acquisition of a new HPV infection.4 Also, the fact that recurrent erosions are a common feature of erosive vulvar LP, may be associated to the increase risk of HPV infection acquisition.