Genital lupus, which just means vulvar symptoms in discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE) is rare. There are clinical reports, meaning that incidence is probably higher than reported.1
Because of the shame or embarrassment sometimes involved in talking about vulvar or vaginal symptoms and time often being a constraint in doctor’s appointments, there is very little information regarding genital lupus.
Women with lupus are more likely to experience unpleasant, untreated symptoms and suffer emotional symptoms that relate to shame and poor body image.2,3
Vulvovaginal symptoms may precede a diagnosis of SLE. Mucosal involvement, such as in the vaginal and vulvar tissues, is not common in lupus.
Symptoms of vulvar lupus (genital lupus)
- Burning of the vagina or vulva
- Lesions on the vulva4
- Itchy vulva or vagina
Research to support mucosal involvement in genital lupus
A study of the prevalence of mucosal involvement in 121 LE patients – 53 SLE and 68 chronic cutaneous LE (CCLE) was investigated.5
Results of the genital lupus study include:
- 11 out of 53 SLE patients and 16 out of 68 CCLE patients had signs of mucosal involvement – 21 per cent and 24 per cent respectively.
- The patterns differed – nasal mucosal lesions were present in both groups (2 per cent and 9 per cent of SLE and CCLE respectively)
- Lichen planus-like plaques on buccal mucosa and the palate occurred in 9 per cent of those with CCLE and 4 per cent of those with SLE.
- Episcleritis occurred in 9 per cent of SLE patients and was not seen in CCLE.
- Lower eyelid plaques were found on 6 per cent of CCLE patients.
- Vulvar lesions were found in 2 female patients with CCLE.
- Lesions may be asymptomatic.
References
- 1.Kudsi M, Drie T, Haidar G, Al-Sayed S, Roumieh E. Genital ulcers associated with systemic lupus erythematosus – what are the possible causes? A Case Report. European Journal of Case Reports in Internal Medicine. Published online July 29, 2023. doi:10.12890/2023_003972
- 2.Liu M, Dou J, Wang Q. The effect of systemic lupus erythematosus on sexual function in women: an updated meta-analysis based on cross-sectional studies. Adv Rheumatol. Published online July 4, 2022. doi:10.1186/s42358-022-00257-0
- 3.Yin R, Xu B, Li L, et al. The impact of systemic lupus erythematosus on women’s sexual functioning. Medicine. Published online July 2017:e7162. doi:10.1097/md.0000000000007162
- 4.Paidi G, V H. A Rare Case of Systemic Lupus Erythematosus Manifesting as Genital Ulcers. Cureus. Published online April 4, 2022. doi:10.7759/cureus.23818
- 5.BURGE SM, FRITH PA, JUNIPER RP, WOJNAROWSKA F. Mucosal involvement in systemic and chronic cutaneous lupus erythematosus. British Journal of Dermatology. Published online December 1989:727-741. doi:10.1111/j.1365-2133.1989.tb08215.x
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