scholarly journals Verruciform xanthoma of the vulva in the context of lichen sclerosus: A mimicker of HPV and p53-independent intraepithelial neoplasia

2021 ◽  
Vol 26 ◽  
pp. 300556
Author(s):  
Simon F. Roy ◽  
Jahg Wong ◽  
Kurosh Rahimi

Ano-genital dermatoses provides information on the following anogenital skin conditions: common benign lesions/anomalies (angiokeratomas, Fordyce spots, epidermoid cysts, epidermal naevi, haemangioma, idiopathic calcinosis of the scrotum, melanocytic naevi, nabothian follicles, pearly penile papules, pigmentary changes, prominent hair follicles, seborrheic keratosis, skin tags, vulval papillae); degenerative condition (ovarian failure); infective conditions (tinea cruris, erythrasma); inflammatory conditions (irritant and contact dermatitis, seborrhoeic dermatitis, fixed drug eruption, psoriasis, lichen planus, plasma cell balanitis, lichen sclerosus, hidradenitis suppuritiva); ulcerative conditions (aphthous ulcers, Lipschutz ulcers, Behçet’s disease, erythema multiforme/Stevens–Johnson syndrome, pyoderma gangrenosum, pemphigus vulgaris); premalignant conditions and malignant conditions (extramammary Paget’s disease, squamous intraepithelial neoplasia). The chapter ends with a table of options for steroids of differing strengths.


2017 ◽  
Vol 103 (6) ◽  
pp. 511-515 ◽  
Author(s):  
Angela Carrone ◽  
Lucia Riganelli ◽  
Delia Savone ◽  
Assunta Casorelli ◽  
Lucia Merlino ◽  
...  

Introduction Two different types of vulvar intraepithelial neoplasia (VIN), HPV-related and HPV-unrelated, should be considered as two separate entities with different management options. The incidence of HPV-related VIN is increasing worldwide and is implicated in carcinogenesis. Our objective is to investigate the use of p16INK4a immunostaining or p16INK4a/p53 double staining for the detection of HPV-related disease to overcome the problem that histological criteria often have significant overlap. Methods A systematic literature search was carried out in the online databases PubMed, EMBASE, Cochrane Library, Clincaltrials.gov and Scopus. The key search terms were HPV, VIN, p16INK4a immunochemistry and p53. Results We found that nuclear and cytoplasmic immunostaining for p16INK4a was intense and diffuse in HPV-associated lesions and weak and focal in normal vulvar epithelium, nondysplastic lesions, lichen sclerosus and keratinizing vulvar squamous cell carcinoma. p53 nuclear immunostaining was always negative in HPV-related disease. Conclusions Our findings indicated that p16INK4a or p16INK4a/p53 immunoreactivity, along with histological diagnosis, could be a convenient means to adequately classify VIN and its connection to HPV infection. Therefore, the clear recognition of HPV-associated VIN would lead to an appropriate strategy of treatment and follow-up.


2020 ◽  
Vol 86 (1) ◽  
pp. 69-77
Author(s):  
V.V. Dunaevskaya ◽  
T.F. Tatarchuk ◽  
O.V. Zanko

A comprehensive approach that includes the treatment of background and precancerous diseases of the vulva by photodynamic therapy and plasma therapy as rehabilitation therapy was developed. The method’s effectiveness was evaluated. The study is also aimed at evaluating the effectiveness of plasma therapy after treatment of background and precancerous diseases of the vulva by photodynamic therapy. The work is based on the study results of 60 patients aged 32 to 70 years old, mean age was (53.3+3.6) years, with a morphologically verified diagnosis of vulvar intraepithelial neoplasia, mixed vulvar dystrophy (Lichen sclerosus et atrophicus, squamous cell hyperplasia), which were divided into two groups. Patients of both groups underwent photodynamic therapy using an intravenous photosensitizer «Fotolon®» (RUE «Belmedpreparaty», Republic of Belarus), which is a complex of chlorine ебс trisodium salt with low molecular weight polyvinylpyrrolidone. The session of photodynamic therapy was performed 3^1 hours after the end of the FS infusion using a universal laser coagulator «Likar-Hirurg (Surgeon)» («Photonica Plus», Ukraine, A-660 nm). Plasma therapy was performed for patients of group 2 after photodynamic therapy. It has been established that the use of photodynamic therapy and plasma therapy increases the effect of treatment of background and precancerous diseases of the vulva, accelerates the period of damaged tissues regeneration and rehabilitation of patients twice and prolongs the recurrence-free period of the disease. Keywords: photodynamic therapy, plasma therapy, precancerous diseases of the vulva.


Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 389
Author(s):  
Lauro Bucchi ◽  
Margherita Pizzato ◽  
Stefano Rosso ◽  
Stefano Ferretti

The aim of this review was an update of vulvar cancer incidence rates and trends and of all known and putative risk factors for the disease. The most recent incidence data were sought from official sources (WHO Cancer Incidence in Five Continents). To obtain an estimate of time trends in some areas, we compared data from Cancer Incidence in Five Continents with the few available studies that measured incidence using comparable methods. With respect to risk factors, a systematic PubMed search identified 1585 relevant articles published between 1980 and 2021. Abstracts and full texts were screened. Sixty-nine eligible original cohort and case-control studies were selected. Information was extracted using a PRISMA predesigned form. Nineteen risk factors, or risk factor categories, were investigated by two or more original studies. Solitary, unreplicated studies addressed the putative role of eight more factors. Recent advances have provided further evidence supporting the carcinogenic model centred on human papillomavirus infection with different defects of the immune function. Conversely, the model centred on the role of vulvar lichen sclerosus and the often associated differentiated vulvar intraepithelial neoplasia has continued to be epidemiologically understudied. More research on the association between these two conditions and vulvar cancer is a priority.


2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Yutaka Ueda ◽  
Takayuki Enomoto ◽  
Toshihiro Kimura ◽  
Kiyoshi Yoshino ◽  
Masami Fujita ◽  
...  

Squamous cell carcinoma (SCC) accounts for approximately 95% of the malignant tumors of the vaginal vulva and is mostly found in elderly women. The future numbers of patients with vulvar SCC is expected to rise, mainly because of the proportional increase in the average age of the general population. Two different pathways for vulvar SCC have been put forth. The first pathway is triggered by infection with a high-risk-type Human Papillomavirus (HPV). Integration of the HPV DNA into the host genome leads to the development of a typical vulvar intraepithelial neoplasia (VIN), accompanied with overexpression of and . This lesion subsequently forms a warty- or basaloid-type SCC. The HPV vaccine is a promising new tool for prevention of this HPV related SCC of the vulva. The second pathway is HPV-independent. Keratinizing SCC develops within a background of lichen sclerosus (LS) through a differentiated VIN. It has a different set of genetic alterations than those in the first pathway, including p53 mutations, allelic imbalances (AI), and microsatellite instability (MSI). Further clinical and basic research is still required to understand and prevent vulvar SCC.Capsule. Two pathway for pathogenesis of squamous cell carcinoma of the value are reviewed.


2021 ◽  
Vol 17 (3) ◽  
pp. 114-120
Author(s):  
V. S. Levchenko ◽  
E. V. Grebenkina ◽  
N. A. Illarionova ◽  
E. N. Koroleva ◽  
S. V. Zinovyev ◽  
...  

Vulvar intraepithelial neoplasia (VIN) is the proliferation of atypical basal cells in the vulvar epithelium. The global VIN incidence has recently doubled; its incidence among white women under 35 years of age has almost tripled with a tendency for further growth. Such an increase in the number of usual-type VIN cases in young women is primarily attributed to infection with highly oncogenic human papillomavirus. The second type of dysplasia, namely differentiated VIN, is usually found in older women and is associated with chronic dystrophic diseases of the vulva, most frequently with lichen sclerosus of the vulva. VIN diagnosis is quite challenging; no screening programs for this disorder have been developed so far. Patients with VIN practice self-treatment for a long time, which aggravates their condition and might trigger the development of vulvar cancer. Several treatment options are currently available; however, their efficacy worldwide is not high.


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