13.1 Vulva Flashcards
Bartholin Cyst
Cystic dilation of the Bartholin gland - arises due to inflammation and obstruction of gland
What is the vulva lined with?
Squamous Epithelium
Who does Bartholin cyst typically occur in?
Women of reproductive age
What is the clinical presentation of bartholin cyst?
Unilateral painful cystic lesion in the lower vestibule adjacent to the vaginal canal
Condyloma
Warty neoplasm of vulvar skin
What is the most common cause of condyloma?
HPV Type 6 and 11
What is characteristic of condylomas?
Koilocytes (crinkled nucleus in cells)
What are the low risk HPVs?
HPV-6 and 11
What are the high risk HPVs?
HPV-16, 18, 31 and 33
16 and 18 MOST common
What is the classic lesion of the low risk HPVs?
Condyloma
What is the main lesion with high risk HPVs?
Dysplasia that can eventually lead to carcinoma
Lichen Sclerosis
Thinning of the epidermis and fibrosis of the dermis
What are the presentations of lichen sclerosis?
Leukoplakia with parchment like vulvar skin
Lichen Simplex Chronicus
Hyperplasia of vulvar squamous epithelium
What are the presentations of lichen simplex chronicus?
Leukoplakia with thick leathery skin
What is lichen simplex chronicus associated with?
Chronic irritation and scratching
What is the risk of SCC with lichen simplex chronicus?
None
What is the typical patient of lichen sclerosis?
Postmenopausal Women
Vulvar Carcinoma
Arises from vulvar squamous epithelium - RARE
How does vulvar carcinoma present?
Presents as leukoplakia
What is the key non-HPV cause of vulvar carcinoma?
Longstanding lichen sclerosis
What is the typical patient of non-HPV vulvar carcinoma?
Elderly women ~70 yrs
Extramammary Paget Disease
Malignant epithelial cells in the epidermis of the vulva
How does extramammary Paget disease present?
Red, pruritic ulcerated skin
What is the staining of Paget cells (carcinoma)?
PAS+, keratin+ and S100-
What is the staining of melanoma?
PAS-, keratin- and S100+
