1/22. cell cycle proteins as molecular markers of malignant change in vulvar lichen sclerosus.Lichen sclerosus (LS) has a known association with the development of squamous cell carcinoma of the vulva. The purpose of this study was to investigate molecular markers, which could indicate premalignant changes. Multiple sequential vulvar biopsies were taken over a period of 11 years from a patient with longstanding LS. Immunohistochemical staining was used to demonstrate a range of molecular markers. Increased expression of p53 and Ki67 was found in areas of squamous hyperplasia (SH) and differentiated vulvar intraepithelial neoplasia (dVIN) which correlated with the subsequent development of invasive squamous cell carcinoma (SCC). Molecular changes have been found to accompany histologic changes in the progression of vulvar LS to malignancy. Such markers may prove a useful addition in the clinical management of these conditions.- - - - - - - - - - ranking = 1keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
2/22. Human papillomavirus-negative spindle cell carcinoma of the vulva associated with lichen sclerosus: case report and literature review.Although spindle cell carcinoma (SC) is a common neoplasm in the oral cavity, upper respiratory tract, and other head and neck areas, its occurrence in the vulva is rare. We report a case of this rare condition with immunohistochemical, ultrastructural, and human papillomavirus (HPV) testing. The neoplastic cells were positive for vimentin, keratins (AE1-AE3, keratin 902, and keratin 903), and epithelial membrane antigen. Ultrastructurally, they showed primitive junctions and tonofilaments. HPV testing by polymerase chain reaction was negative. In addition, we review the clinicopathologic findings of the four well-documented cases of vulvar SC that have been reported previously in the English language literature.- - - - - - - - - - ranking = 0.94401309666917keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
3/22. Vulvar malignant melanoma associated with human papillomavirus dna: report of two cases and review of literature.Oncogenic human papillomavirus (HPV) types such as HPV 16 are known to play a crucial role in the development of anogenital carcinomas. The etiology of anogenital malignant melanoma is unknown. We report two case of vulvar malignant melanoma in which multiple HPV types including HPV 16 and putative novel HPV types (alb-1, alb-2, alb-7, and alb-10) were identified by degenerated nested polymerase chain techniques (polymerase chain reaction) in both the malignant melanoma and surrounding skin. One melanoma was associated with lichen sclerosus, and the other, with melanoma in situ and pigmented vulvar squamous papillomatosis. These melanomas harbored HPV types alb-7, and HPV 16 as well as alb-1, respectively. HPV types 16, 20, 21, 36, alb-2, and AJ001060 were detected in vulvar skin affected by lichen sclerosus. Vulvar squamous papillomatosis harbored HPV types 28 and alb-10. HPV 16 was physically integrated into the host genome in lichen sclerosus skin and possibly in the melanoma associated with pigmented vulvar squamous papillomatosis. Twenty-two percent (4 of 18) of normal control specimens from skin tumor excisions were found to harbor HPV dna (HPV types 3, 54, and alb-7); none of these control samples harbored multiple HPV dna. These findings of multiple HPV dna and integrated HPV 16 in skin associated with vulvar malignant melanoma indicate that HPV may play a role in the development of vulvar malignant melanoma. The role of HPV could be either direct through infection of melanocytes or indirect as a cofactor with free radicals in chronic fibroinflammatory vulvar disorders such as lichen sclerosus.- - - - - - - - - - ranking = 0.94401309666917keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
4/22. Extramammary Paget's disease masquerading as lichen sclerosus.A wide range of genital infections and skin conditions may present with vulval pruritus. Lichen sclerosus is one cause. This is often associated with visible skin changes which include atrophy, resorption or fusion of the labia, sclerosis and excoriation. Ulceration may indicate malignant transformation and requires urgent biopsy. Many experienced clinicians diagnose lichen sclerosus on clinical appearance, however we recommend a low threshold for biopsy, especially for non-responding or odd looking lesions. We report a patient whose vulval skin biopsy for clinically suspected lichen sclerosus revealed extramammary Paget's disease of the vulva. We review the pathology, prognosis and treatment of this condition.- - - - - - - - - - ranking = 1.4720065483346keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
5/22. The simplex (differentiated) variant of vulvar intraepithelial neoplasia.BACKGROUND: The simplex (differentiated) variant of vulvar intraepithelial neoplasia is rarely reported. It is regarded as more likely than "classic" carcinoma in situ to be associated with invasion and can be easily mistaken for benign lesions. OBJECTIVE: The objective was to present a case of simplex variant of vulvar intraepithelial neoplasia in a 67-year-old woman that was initially misdiagnosed as lichen simplex chronicus. methods: A case report is reported and the literature is reviewed. RESULTS: Surgical excision with a free margin of 5 mm was performed and no evidence of recurrence was noted during the follow-up period of 6 months. CONCLUSION: The simplex vulvar intraepithelial neoplasia is an easily overlooked premalignant disease, and it can be cured with surgical treatment if diagnosed correctly and early.- - - - - - - - - - ranking = 0.0030674133963904keywords = lichen (Clic here for more details about this article) |
6/22. Malignant melanoma associated with lichen sclerosus in the vulva of a 10-year-old.Malignant melanoma of the vulva in childhood is a rare neoplasm. Lichen sclerosus of the vulva in childhood is also a rare disease. The association of these two rare lesions in the vulva of young girls is extremely rare. We present a 10-year-old white girl with malignant melanoma associated with lichen sclerosus of the vulva. She had dark pigmentation of both the labia minora and posterior fourchette. The inner labia majora and fourchette showed whitish, glistening areas of skin. Histologic examination found mostly an in situ lentiginous/mucosal melanoma with focal invasion to a depth of 0.44 mm in the left upper labium majus. All specimens showed evidence of lichen sclerosus. Partial vulvectomy was performed, and no metastases were detected at the time of treatment. The patient has been disease free for the 12 months after treatment. It is critical for physicians to realize that melanoma can occur in children, and although rare, can occur in the vulva. We feel that lichen sclerosus in this instance may represent a pattern of host immune response to melanoma.- - - - - - - - - - ranking = 1.7080098225019keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
7/22. A persistently recurring peri-urethral soft tissue lesion of the vulva.Various mesenchymal lesions, some of which have only recently been characterized, may affect the vulva. Because of their apparently shared origin from vulvovaginal mesenchyme, these lesions can resemble one another superficially and can be challenging diagnostically. Clinically, benign lesions and tumor-like conditions may mimic a malignant process because of hypercellularity, mitotic activity, and rapid growth. We report on a 84-year-old diabetic and hypertensive woman who had previously undergone skinning vulvectomy for lichen planus and an embolectomy of the left femoral artery. The patient presented with a rapidly growing vulvar mass. The biopsy showed spindle cell proliferation in a loose myxoid stroma with granulation tissue and a mixed inflammatory infiltrate. Based on histology and immunohistochemistry, the initial diagnosis was that of a benign lesion. In view of the persistent recurrence of the lesion and the absence of metastatic spread, we conclude that the lesion has a low-grade malignant potential and suggest the diagnosis of florid cellular reactive pseudosarcomatous myofibroblastic proliferation.- - - - - - - - - - ranking = 0.0030674133963904keywords = lichen (Clic here for more details about this article) |
8/22. Vaginal and vulvar adenosis. An unsuspected side effect of CO2 laser vaporization.During a 15-month period, September 1984 through January 1986, 10 women who were treated in the Section of Gynecologic Oncology, Department of obstetrics and gynecology, pennsylvania Hospital, philadelphia, pennsylvania, developed vaginal or vulvar adenosis after CO2 laser vaporization. The indications for therapy were condylomata of the cervix, vagina and vulva refractory to conservative management in 3 patients, vulvar intraepithelial neoplasia in 3, lichen sclerosus in 1 and cervical intraepithelial neoplasia with condylomata on the cervix and vagina in 3. All the patients underwent treatment of the vagina. Most underwent treatment of the cervix, and some underwent treatment of the vulva at various degrees of intensity and depth. During the posttreatment colposcopic follow-up examination, all the patients demonstrated lesions colposcopically consistent with adenosis of the vagina or vulva within the area treated with the CO2 laser. Biopsies of the lesions were performed, adenosis was confirmed histologically, and endometriosis was ruled out histologically. This entity has not been previously associated with CO2 laser vaporization, and its clinical significance is undetermined. Further follow-up is indicated.- - - - - - - - - - ranking = 0.23600327416729keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
9/22. nevus elasticus and lichen sclerosus et atrophicus on the vulva.A sixty-seven-year-old woman had complained of vulvar pruritus and vaginal soreness for eight months. Clinical and histologic examination showed an admixture of two different entities: nevus elasticus and lichen sclerosus et atrophicus.- - - - - - - - - - ranking = 1.1800163708365keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
10/22. Acquired dyskeratotic leukoplakia.A 36-year-old woman developed progressive dyskeratotic leukoplakia of the palate, lips, attached gingiva, and labial surfaces of the genitalia. On microscopic examination, clusters of dyskeratotic cells were found throughout the epithelium, except in the basal cell layer. The clinical and histologic differential diagnosis included candidiasis, oral hairy leukoplakia, lichen planus, condyloma acuminatum, Darier's disease, hereditary benign intraepithelial dyskeratosis, and white sponge nevus. Her clinical and histologic findings do not permit classification into any of these well-recognized entities.- - - - - - - - - - ranking = 0.0030674133963904keywords = lichen (Clic here for more details about this article) |
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