1/9. Acantholytic dermatosis of the vulvocrural area.Acantholytic dermatosis of the vulvocrural area is a rare skin disorder characterized by solitary or multiple skin-colored to white, smooth papules or plaques. Histopathological features of both Hailey-Hailey disease and Darler's disease are present. There is acantholysis, which may involve the full thickness of the epidermis, and dyskeratosis with corps ronds and grains. There may be marked hyperkeratosis and focal parakeratosis. We report a case of this rare disease and discuss its differential diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = dermatosis (Clic here for more details about this article) |
2/9. Cytology of extramammary Paget's disease of the vulva. A case report.BACKGROUND: Paget's disease of the vulva (PDV) is a rare entity, with only a few cytologic descriptions having been published on it. Diagnosis is usually delayed because it is often clinically mistaken for some types of dermatosis, and biopsy is usually postponed. CASE: A 56-year-old woman presented with a pruritic, erythematous and ulcerated superficial lesion on the right labium majus of approximately eight months' duration. A vulvar cytologic smear showed a bloody and inflammatory background with many single malignant cells; scarce malignant cell aggregates; and abundant, mature squamous and dyskeratotic cells. The tumor cells were large, with a frequently eccentric, large nucleus. Some binucleated forms were noted. Nucleoli were rare. cytoplasm varied from pale and delicate to densely basophilic. Intracytoplasmic vacuoles were very rare. Tumor cell aggregates were small and exhibited pseudocannibalism. Short strands of malignant cells arranged in an Indian file pattern were also evident. Histologic examination of a wedge biopsy, wide local excision of the lesion and simple vulvectomy showed PDV. CONCLUSION: knowledge of the cytologic features of PDV could provide a highly probable cytologic diagnosis of the disease and should alert the clinician to the need for immediate biopsy. Systematic collecting of smears from any eczematous change in the vulva should be considered a first step to early diagnosis of malignancy.- - - - - - - - - - ranking = 0.2keywords = dermatosis (Clic here for more details about this article) |
3/9. Vulvar lichen planus associated with ulcerative colitis. A case report.BACKGROUND: lichen planus (LP) is a common inflammatory dermatosis the diagnosis of which can be very complex when it affects the female genital area exclusively. The condition should be managed by both dermatologists and gynecologists because the association between vulvar LP and other immune-mediated disorders occurs frequently. CASE: Vulvar LP was diagnosed in 37-year-old woman whose past history was significant for ulcerative colitis (UC) since the age of 21. The oral mucosa and skin were completely unaffected, but whitish papules and plaques were seen diffusely on the whole vulvar region, which had become sclerotic and edematous. Microscopic examination of lesional tissue confirmed the diagnosis, showing classic histologic features in spite of the mixed and hypertrophic clinical variant. Oral therapy with cyclosporin at an initial dose of 250 mg/d led to complete remission within 3 months. CONCLUSION: This case is reported on for the rarity of isolated vulvar involvement by LP and for the excellent response to treatment.- - - - - - - - - - ranking = 0.2keywords = dermatosis (Clic here for more details about this article) |
4/9. Vulvar cicatricial pemphigoid of childhood.We report a 9-year-old girl with a vulvar autoimmune bullous dermatosis. A diagnosis of localized bullous pemphigoid or cicatricial pemphigoid was made on the basis of immunohistologic data. Since the lesions were unresponsive to topical corticosteroids but healed completely on dapsone at a dosage of 1.5 mg/kg/day, we favor the diagnosis of vulvar cicatricial pemphigoid. Only two such cases have been reported thus far. The diagnostic criteria and therapeutic modalities are discussed.- - - - - - - - - - ranking = 0.2keywords = dermatosis (Clic here for more details about this article) |
5/9. A case of vulvar pyoderma gangrenosum associated with collagenous colitis.pyoderma gangrenosum is a reactive inflammatory dermatosis which belongs to the spectrum of neutrophilic dermatoses. Due to a lack of diagnostic criteria, pyoderma gangrenosum is mainly a diagnosis of exclusion. It is rarely observed on the perineum, and vulvar involvement is even less frequent. Collagenous colitis is an idiopathic inflammatory colonic disease that is included in the microscopic colitides. The colonic mucosa and the crypt architecture are preserved but histologic alterations are found. We describe a case of collagenous colitis associated with vulvar pyoderma gangrenosum that improved spectacularly with cyclosporine 3 mg/kg/day and the twice-daily application of topical tacrolimus 0.1%.- - - - - - - - - - ranking = 0.2keywords = dermatosis (Clic here for more details about this article) |
6/9. A case of acantholytic dermatosis of the vulva with features of pemphigus vegetans.We report an unusual case of vulvar acantholytic dermatosis with features of pemphigus vegetans in a 22-year-old Indian girl who presented with a "warty" lesion in her left labium majus. Following excision of this lesion, she presented with 2 localized recurrent lesions on the left and right labia majora about 2 1/2 years later which were also excised. All 3 biopsies showed histological features typical of pemphigus which included extensive suprabasal acantholysis with bullae formation, prominent villus-like processes at the base of the bullae, focal hyperkeratosis and papillomatosis, and the occasional mixed neutrophil and eosinophilic intraepidermal abscess. IgG and C3 immunofluorescence was positive in the intercellular spaces of the epidermis. These lesions, which probably represent a form of pemphigus vegetans, have not been previously reported as a cause of localized vulvar acantholytic dermatosis.- - - - - - - - - - ranking = 1.2keywords = dermatosis (Clic here for more details about this article) |
7/9. Sweet's syndrome associated with Behcet's disease.A case of acute febrile neutrophilic dermatosis (Sweet's syndrome) associated with Behcet's disease occurring in a 48 year old woman is reported. She fulfilled the diagnostic criteria for both Sweet's syndrome and Behcet's disease. There have been several reports of this association. herpes simplex virus was isolated from a genital ulcer in our patient. The possible role of herpes simplex virus in this interesting association of Behcet's disease and Sweet's syndrome is discussed and a review of the literature is made.- - - - - - - - - - ranking = 0.2keywords = dermatosis (Clic here for more details about this article) |
8/9. Chronic vulvar ulceration in an immunocompetent woman due to acyclovir-resistant, thymidine kinase-deficient herpes simplex virus.A 34-year-old healthy woman presented with a 15-month history of persistent, nonhealing vulvar ulcerations due to herpes simplex virus (HSV) type 2. Extensive dermatologic workup and serial skin biopsies failed to reveal an underlying vulvar dermatosis or autoimmune bullous disorder. Virologic studies revealed resistance to acyclovir in vitro due to deficiency in thymidine kinase activity. serum antibody to human immunodeficiency virus was negative on two occasions, separated by 1 year. Immunologic evaluation showed normal HSV-specific proliferative and CD8 cytotoxic T lymphocyte responses as well as normal NK cell function. Vulvar lesions failed to heal in association with trials of topical trifluorothymidine and oral valacyclovir but resolved completely with the application of 1% foscarnet cream. No recurrence of HSV has been observed in 24 months of follow-up to date.- - - - - - - - - - ranking = 0.2keywords = dermatosis (Clic here for more details about this article) |
9/9. STD case challenge--differential diagnosis of a genital dermatosis.A 25-year-old white woman arrives in your outpatient clinic with a red, nonpruritic genital rash. What is the differential diagnosis and treatment?- - - - - - - - - - ranking = 0.8keywords = dermatosis (Clic here for more details about this article) |