Zoon vulvitis
Jump to navigation
Jump to search
The printable version is no longer supported and may have rendering errors. Please update your browser bookmarks and please use the default browser print function instead.
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
- Rare ~ 50 reported cases in English literature as of 2012.[3]
- Analogous to Zoon's balanitis in males.[4]
Clinical:[3]
- Pruritis.
- Pain.
- Orange colouration.[5]
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.
- Keep in mind that plasma cells are a common component of mucosal infiltrates, much more so than for skin.
- A plasma cell component has to be relatively prominent to be relevant in this location (the same can be said for eosinophils).
- Hemosiderin deposits.[6]
DDx:
- Syphilis - Spirochete immunostain (in red) is helpful.
- Spongiotic vulvitis.
- Might look very similar.
- Usually wont show iron deposition.
- Clinical correlation important.
- Superficial fungal vulvitis (usually Candida).
- Lichenoid vulvitis (lichen planus/lichenoid drug reaction).
- Both can be very plasmocellular on mucosal surfaces.
- Zoon vulvitis won't show prominent lichenoid destruction of the epithelium.
Images
www:
IHC
- CD138 -- to highlight plasma cells.
Sign out
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. Perls stain positive iron is admixed with the inflammatory infiltrate.
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 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.
- ↑ 3.0 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.
- ↑ 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.
- ↑ URL: http://www.dermnetnz.org/site-age-specific/plasma-cell.html. Accessed on: October 29, 2014.
- ↑ Davis, J.; Shapiro, L.; Baral, J. (Mar 1983). "Vulvitis circumscripta plasmacellularis.". J Am Acad Dermatol 8 (3): 413-6. PMID 6833541.