bubble_chart Concept

Vulvar leukoplakia refers to atrophic white lesions occurring in the vulvar area. The affected areas can be on the labia majora, labia minora, clitoris, and may extend to the perineum, anus, and groin.

Although there is no record of the disease name "vulvar leukoplakia" in traditional Chinese medicine, based on clinical symptoms, it can be categorized under the scope of "pudendal itch," "swelling of vulva," "pudendal sore," and "vaginal pain."

bubble_chart Pattern Analysis

1. Dampness-heat in Liver Meridian︰Redness, swelling, and itching in the genital area, hypopigmentation of the skin, or accompanied by eczema, excessive yellowish leukorrhea, or bitter taste in the mouth with dark urine. The tongue coating is yellow and greasy or thin yellow, and the pulse is wiry and thin or wiry and slippery. It is caused by damage from the seven emotions, dampness-heat in the liver meridian, multiple abscesses in the lower energizer, which soak and affect the female genitalia. This condition is commonly seen in the initial stage [first stage] of leukoplakia of the vulva, with symptoms such as redness, swelling, and itching in the genital area, hypopigmentation of the skin, or accompanied by eczema, excessive yellowish leukorrhea, bitter taste in the mouth with dark urine, a yellow and greasy or thin yellow tongue coating, and a wiry and slippery pulse. The treatment should focus on clearing the liver and draining fire, harmonizing blood, and draining dampness. The recommended formula is Gentian Liver-Draining Decoction with modifications.
2. Spleen Deficiency with Dampness Retention︰The vulvar skin appears white, thickened, with ulceration and discharge, pain, and excessive leucorrhea. The tongue coating is thick and greasy white, and the pulse is soggy and thin. This is due to spleen deficiency failing to transform and transport water-dampness, leading to dampness stagnation transforming into heat. Dampness-heat pours downward, soaking the vulva. Additionally, spleen deficiency fails to perform its nourishing, moistening, and lubricating functions, resulting in whitening and thickening of the vulvar skin, ulceration with discharge, pain, excessive leucorrhea, a white and greasy tongue coating, and a soggy, thin pulse. Treatment should focus on clearing and draining damp-heat, fortifying the spleen, and relieving itching. The recommended formula is Dampness-Eliminating Decoction.
3. Liver Hyperactivity Due to Blood Deficiency︰Vaginal stabbing pain, unbearable itching, especially severe at night, vulvar skin dry and whitened, loss of elasticity, dizziness and dizzy vision, scanty menstruation. Thin white tongue coating, pale tongue texture, wiry and weak pulse. Predominantly blood deficiency with wind-dryness, clinical features include: vulvar skin dry and whitened, loss of elasticity, accompanied by manifestations of blood deficiency and liver hyperactivity (such as dizziness and dizzy vision, scanty menstruation, thin tongue coating, pale tongue texture, wiry and weak pulse). Treatment involves nourishing blood, activating blood circulation, clearing the liver and dispelling wind. The prescription uses Four Ingredients Decoction with Puncturevine Caltrop Fruit, suberect spatholobus stem, Sichuan续断 (Dipsacus asperoides), Arnebia, and stemona root.
4. Liver-kidney Yin Deficiency︰Vaginal itching and atrophy, pale in color, soreness and weakness in the lower back and knees, or dizziness and dizzy vision, irritability, and insomnia. The tongue texture is red with thin coating, and the pulse is thin and rapid. It is primarily due to insufficient essence-yin, with clinical features including: vulvar itching, atrophy with pale color, accompanied by signs of liver-kidney yin deficiency (such as soreness and weakness in the lower back and knees, dizziness and dizzy vision, irritability, insomnia, red tongue texture, and thin, rapid pulse). The treatment should focus on nourishing water to moisten wood, harmonizing blood, and moisturizing the skin. The recommended formula is Wolfberry and Chrysanthemum Rehmannia Pill supplemented with Chinese Angelica and Red Peony Root.
5. Kidney Yang Deficiency︰The vulva is dry, pale in color, with cracks, and even atrophy, loss of elasticity, accompanied by local itching or stabbing pain, scanty menstruation or amenorrhea, cold pain in the lower abdomen, soreness and lack of strength in the lower back. The tongue is pale with a thin coating, and the pulse is deep, thin, and weak at the chi position. This is caused by kidney yang deficiency and the inability of essential qi to nourish the genitalia, leading to dryness, atrophy, and whitening of the vulvar skin. Clinically, this condition is often seen in cases of long-standing vulvar leukoplakia, presenting as dryness, whitening with cracks, or even atrophy, loss of elasticity, difficulty in sexual intercourse, local itching or stabbing pain, scanty menstruation or amenorrhea, cold pain in the lower abdomen, soreness and weakness in the lower back, and a weak chi pulse. Treatment should focus on warming the kidney and assisting yang, dispelling wind, and relieving itching. The recommended formula is Right-Restoring Decoction supplemented with Cnidium Fruit, Epimedium Herb, and Chinese Clematis Root.

Although the lesion of vulvar leukoplakia is located in the perineal area, according to the concept of holism in Chinese medicine and the dialectical method of "examining the syndrome to seek the cause," combined with clinical practice, it is often related to the dysfunction of the liver, spleen, and kidney, as well as the abnormal circulation of qi and blood in the Chong, Ren, and Du vessels. In the initial stage, symptoms often manifest as redness, swelling, and itching, commonly due to dampness-heat pouring down the spleen meridian and dampness-heat in the liver meridian. Over time, it may progress to blood deficiency with liver hyperactivity, liver-kidney yin deficiency, and kidney deficiency with yang decline. In the late stage, the vulva may exhibit dryness, cracking, atrophy, a sensation of insects crawling, localized intense itching, or needle-like pain. Treatment should be based on pattern identification, combined with external medications such as fumigation and washing with the leukoplakia fumigation formula, topical application of vulvar leukoplakia ointment, or acupuncture therapy, which can yield better results.