Vulva

Non-neoplastic disorders

Infections

Lichen Sclerosis

Thinning of epidermis with fibrosis of the dermis

post-menopause

porcelain-whtite plaques with red or violet border

benign, increased risk for SCC

Lichen Simplex Chronicus

Hyperplasia of vulvar squamous epithelium

leukoplakia -leathery thick skin with enhanced markings

maybe lots of rubbing

benign, no risk of SCC

Bartholin Cyst

N. gonorrhea

due to blockage of the Bartholin gland duct, causing an accumulation of gland fluid

May lead to abscess, 2/2 obstruction and inflammation

reproduction age females

Lower vestibule adjacent to vaginal canal

Condyloma (HPV)

Most commonly HPV 6 and 11

characterized by koilocytic change, hallmark of HPV infected cels

Low oncogenic potential

Molluscum contagiousum

DNA Pox virus

Neoplastic

Vulvar Carcinoma

Squamous epithelium

Leukoplakia, must do biopsy to differentiate from other nonneoplasms

HPV Related vs nonHPV

16 and 18/VIN

lichen sclerosis

Multiple partners, early coitarche

Extramammary Pagets disease

Intraepithelial adenocarcinoma

PAS +, keratin +, S100 -

Carcinoma in situ, low risk of underlying carcinoma

Pruritus, erythema, crusting, ulcers

distinguish from melanoma S100+