Zoon vulvitis

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Zoon vulvitis, also vulvitis circumscripta plasmacellularis[1] and plasma cell vulvitis, is a rare pathology of the vulva.

General

Clinical:[2]

  • Pruritis.
  • Pain.

Gross

Features:[2]

  • Erythematous macules or papules.

Microscopic

Features:

  • Squamous epithelium with:[4]
    • Spongiosis.
    • Lack of stratum granulosum and stratum corneum layers.
    • "Lozenge"-shaped (diamond-like shape).
  • Abundant plasma cells - esp. superficial dermis.
  • Hemosiderin deposits.[5]

DDx:

Images

IHC

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LESION, VULVA, BIOPSY:
- SQUAMOUS MUCOSA WITHOUT A CORNIFIED ZONE, WITH MARKED CHRONIC INFLAMMATION
  WITH PROMINENT PLASMA CELLS, SEE COMMENT.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

COMMENT:
A p16 immunostain is negative. Ki-67 positive cells are basal. No microorganisms are
apparent with a PASF stain.

A CD138 immunostain demonstrates clusters of plasma cells. The loss of the cornified zone
and prominent plasma cells is consistent with plasma cell vulvitis (Zoon vulvitis). 

Clinical correlation is suggested.

See also

References

  1. dos Reis, HL.; de Vargas, PR.; Lucas, E.; Camporez, T.; Ferreira, Dde C.. "Zoon vulvitis as a differential diagnosis in an HIV-infected patient: a short report.". J Int Assoc Provid AIDS Care 12 (3): 159-61. doi:10.1177/2325957412467694. PMID 23449712.
  2. 2.0 2.1 2.2 2.3 Çelik, A.; Haliloglu, B.; Tanriöver, Y.; Ilter, E.; Gündüz, T.; Ulu, I.; Midi, A.; Özekici, Ü.. "Plasma cell vulvitis: a vulvar itching dilemma.". Indian J Dermatol Venereol Leprol 78 (2): 230. doi:10.4103/0378-6323.93664. PMID 22421677.
  3. Yoganathan, S.; Bohl, TG.; Mason, G. (Dec 1994). "Plasma cell balanitis and vulvitis (of Zoon). A study of 10 cases.". J Reprod Med 39 (12): 939-44. PMID 7884748.
  4. Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 11. ISBN 978-0443069208.
  5. Davis, J.; Shapiro, L.; Baral, J. (Mar 1983). "Vulvitis circumscripta plasmacellularis.". J Am Acad Dermatol 8 (3): 413-6. PMID 6833541.