Zoon vulvitis
Zoon vulvitis, also vulvitis circumscripta plasmacellularis[1] and plasma cell vulvitis, is a rare pathology of the vulva.
General
- Rare ~ 50 reported cases in English literature as of 2012.[2]
- Analogous to Zoon's balanitis in males.[3]
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:
- Syphilis.
- Lichenoid drug reaction.
Images
IHC
- CD138 -- to highlight plasma cells.
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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
- ↑ 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.
- ↑ 2.0 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.
- ↑ 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.
- ↑ 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.
- ↑ Davis, J.; Shapiro, L.; Baral, J. (Mar 1983). "Vulvitis circumscripta plasmacellularis.". J Am Acad Dermatol 8 (3): 413-6. PMID 6833541.