How is squamous cell hyperplasia (lichen simplex chronicus) diagnosed?

Although a vulvar expert can suspect this condition by looking at it carefully under magnification (colposcopy), the symptoms and appearance of squamous cell hyperplasia (lichen simplex chronicus) can mimic a number of other vulvar skin conditions. The only way to be sure of the diagnosis of squamous cell hyperplasia (lichen simplex chronicus) is to take a small piece of skin and send it to the laboratory for examination.  This is called a biopsy. It can be done in the doctor's office. A local anesthetic is injected to numb the skin (similar to the dentist's office) and then a small piece of skin is removed and sent for analysis. Sometimes, even though the biopsy does not show squamous cell hyperplasia (lichen simplex chronicus), the patient's story and the vulvar appearance are so suggestive that the doctor will treat you anyway for the condition.