Vulvar leukoplakia is a painful disease for women, once using the names primary vulvar atrophy, vulvar dryness and sclerosing atrophic moss, and atrophic dystrophy; the current generic name is vulvar sclerosing moss VLS (vulvar lichen sclerosus). It is a common lymphocyte-mediated chronic inflammatory non-neoplastic skin lesion that occurs in the female vulva and is characterized by atrophic thinning of the vulvar and perianal skin and mucosa. Sclerosing moss occurs most often in postmenopausal women, but is not uncommon in prepubertal girls. From a pathological histological point of view, vulvar sclerosing moss can be divided into three types: atrophic (classic) sclerosing moss, chronic simple moss combined with sclerosing moss, and differentiated vulvar intraepithelial neoplasia-prone sclerosing moss. The latter two classifications reflect the inflammatory and neoplastic tendencies of the lesions, respectively. The malignancy rate of sclerosing moss of the vulva is 2/100,000 and increases with age, with a rate of approximately 25/100,000 after age 75. Clinical manifestations of vulvar sclerosing moss The most frequent symptom of vulvar sclerosing moss is intense itching, followed by pain caused by erosions, especially during urination, defecation, and sexual intercourse. The classic skin texture of vulvar sclerosing moss changes to well-defined white patches, wrinkled or cellophane like manifestations. The lesions are symmetrically distributed, starting from the clitoral prepuce and mainly involving the perineum and perianal skin. However, it does not affect the keratinization of the labia majora or hair growth. Skin fragility is a characteristic feature of vulvar sclerosing lichen planus manifested by purpura, erosions and chancroid. Prolonged presence of lesions may be accompanied by invagination of vulvar structures, absence of labia minora and clitoris buried in scarified clitoral cap, causing urination disorders, painful urination, blood in stool, etc. Sometimes adhesions in front and behind the vaginal opening eventually lead to narrowing of the vaginal opening, resulting in difficulties in sexual intercourse and even psychological disorders. Pathogenesis of vulvar sclerosing moss The pathogenesis of vulvar sclerosing moss may be multifactorial at present, including autoimmune, cell proliferation, infectious factors, hormone, genetic and local irritation factors, etc. Treatment of vulvar sclerosing moss Vulvar sclerosing moss is a local benign lesion and should be treated conservatively as the first choice. The purpose of treatment is to relieve symptoms, prevent adhesions and avoid recurrence. For patients with ineffective drug treatment or severe adhesions. Surgical treatment may be an option.