A patient with parchment-like vulvar skin is most likely diagnosed with which condition?

Lichen sclerosis is characterized by parchment-like, thin skin, particularly affecting the vulvar area in women. This condition leads to fibrosis and atrophy of the skin, creating a striking appearance that can be associated with white patches and irritation. Patients may experience chronic itching, pain, and in some cases, scarring, which can further contribute to the parchment-like texture of the affected skin.

Lichen simplex chronicus, while it may cause thickening of the skin due to chronic scratching and irritation, typically does not present with the same parchment-like appearance. Instead, this condition manifests as lichenified, thickened skin that is often hyperpigmented or excoriated due to the persistent itching.

Vulvar Intraepithelial Neoplasia (VIN) refers to precancerous changes in the vulvar epithelium and may present with various lesions, but it would not specifically produce the parchment-like skin characteristic of lichen sclerosis. Similarly, vulvar carcinoma is a malignant tumor and could present with a range of symptoms and lesions, but the classic appearance described aligns more closely with lichen sclerosis.

Thus, based on the presentation of parchment-like vulvar skin, lichen sclerosis is the most likely diagnosis.