Genital involvement in discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE) is rare, however clinical reports do exist, and incidence is probably higher than reported.
Because of the discomfort involved in talking about it – and the fact that a physician is unlikely to bring it up and time is often a constraining factor in appointments – there is very little information regarding genital lupus. This means that the patient is likely to have discomfort and suffer emotional symptoms that relate to shame and poor body image.
Vulvovaginal symptoms may precede a diagnosis of SLE. Mucosal involvement – such as the vaginal and vulvar tissues – is not common, but is certainly present.
Research to support mucosal involvement
A study 1 of the prevalence of mucosal involvement in 121 LE patients – 53 SLE and 68 chronic cutaneous LE (CCLE) was investigated.
- 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.