Author(s): Chan MP, Zimarowski MJ
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Abstract BACKGROUND: Vulvar dermatoses are often difficult to classify due to histopathologic overlap. We aimed to report our experience at a single institution. METHODS: A total of 183 non-neoplastic, non-infectious vulvar biopsies were reviewed. Associations between histopathologic features and specific diagnoses were analyzed by Chi-squared tests. RESULTS: Twenty-two biopsies (12.0\%) showed two concurrent processes. A limited differential rather than a definitive diagnosis was rendered in 15 cases (8.2\%). The final diagnoses included lichen sclerosus (LS) (38.8\%), lichen simplex chronicus (LSC) (29.0\%), eczematous dermatitis (23.0\%), Zoon vulvitis (8.2\%), non-specific/resolved dermatitis (5.5\%), hidradenitis suppurativa (2.7\%), Behçet disease (2.2\%), lichen planus (1.6\%), ruptured cyst (1.6\%), ulcer not-otherwise-specified (1.6\%), psoriasis (1.1\%), radiation dermatitis (1.1\%), sebopsoriasis (1.1\%), seborrheic dermatitis (1.1\%), epidermolytic hyperkeratosis (0.5\%) and granular parakeratosis (0.5\%). Early LS and Zoon vulvitis were commonly included as part of a differential diagnosis. LS was associated with wiry collagen with lymphocyte entrapment (p = 0.0188). LSC was associated with zones of pale epithelium (p = 0.0084), and often displayed prominent fibroblasts (p = 0.0555). Zoon vulvitis was frequently misdiagnosed, and was associated with basal keratinocytic crowding (p < 0.0001). CONCLUSIONS: Our study has determined the relative frequencies of a wide variety of vulvar dermatoses, and identified new diagnostic clues for early LS, LSC and Zoon vulvitis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
This article was published in J Cutan Pathol
and referenced in Journal of Womens Health Care