Difference between revisions of "Zoon vulvitis"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =  Plasmacytosis mucosae -- high mag.jpg
| Width      =
| Caption    = Zoon vulvitis. [[H&E stain]].
| Synonyms  = [[plasmacytosis mucosae]]
| Micro      = squamous epithelium with: spongiosis, lack of ''stratum granulosum'' and ''stratum corneum'' layers, "lozenge"-shaped (diamond-like shape); abundant plasma cells - esp. superficial dermis; +/-hemosiderin deposits
| Subtypes  =
| LMDDx      = [[syphilis]], fungal infection
| Stains    = PASF -ve
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[vulva]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  = pruritis, pain
| Prevalence =
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Zoon vulvitis''', also '''vulvitis circumscripta plasmacellularis'''<ref>{{Cite journal  | last1 = dos Reis | first1 = HL. | last2 = de Vargas | first2 = PR. | last3 = Lucas | first3 = E. | last4 = Camporez | first4 = T. | last5 = Ferreira | first5 = Dde C. | title = Zoon vulvitis as a differential diagnosis in an HIV-infected patient: a short report. | journal = J Int Assoc Provid AIDS Care | volume = 12 | issue = 3 | pages = 159-61 | month =  | year =  | doi = 10.1177/2325957412467694 | PMID = 23449712 }}</ref> and '''plasma cell vulvitis''', is a rare pathology of the [[vulva]].
'''Zoon vulvitis''', also '''vulvitis circumscripta plasmacellularis'''<ref>{{Cite journal  | last1 = dos Reis | first1 = HL. | last2 = de Vargas | first2 = PR. | last3 = Lucas | first3 = E. | last4 = Camporez | first4 = T. | last5 = Ferreira | first5 = Dde C. | title = Zoon vulvitis as a differential diagnosis in an HIV-infected patient: a short report. | journal = J Int Assoc Provid AIDS Care | volume = 12 | issue = 3 | pages = 159-61 | month =  | year =  | doi = 10.1177/2325957412467694 | PMID = 23449712 }}</ref> and '''plasma cell vulvitis''', is a rare pathology of the [[vulva]].


Revision as of 23:28, 13 May 2014

Zoon vulvitis
Diagnosis in short

Zoon vulvitis. H&E stain.
Synonyms plasmacytosis mucosae
LM squamous epithelium with: spongiosis, lack of stratum granulosum and stratum corneum layers, "lozenge"-shaped (diamond-like shape); abundant plasma cells - esp. superficial dermis; +/-hemosiderin deposits
LM DDx syphilis, fungal infection
Stains PASF -ve
Site vulva
Symptoms pruritis, pain

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

It is also known as plasmacytosis mucosae,[2] which may be used to refer to Zoon balanitis.

General

Clinical:[3]

  • Pruritis.
  • Pain.

Gross

Features:[3]

  • Erythematous macules or papules.

Microscopic

Features:

  • Squamous epithelium with:[2]
    • 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:
The loss of the cornified zone and prominent plasma cells is consistent 
with plasma cell vulvitis (Zoon vulvitis). Clinical correlation is suggested.

A CD138 immunostain demonstrates clusters of plasma cells. A p16 immunostain 
is negative. Ki-67 positive cells are basal. No microorganisms are apparent 
with a PASF stain.

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 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.
  3. ↑ 3.0 3.1 3.2 3.3 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.
  4. ↑ 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.
  5. ↑ Davis, J.; Shapiro, L.; Baral, J. (Mar 1983). "Vulvitis circumscripta plasmacellularis.". J Am Acad Dermatol 8 (3): 413-6. PMID 6833541.
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