HIGH YIELD-VULVA

Question 1

what are the types of vulvar dystrophies?

Answer 1

lichen sclersus

squamous hyperplasia

Question 2

also known as chronic atrophic vulvitis that leads to atrophy, fibrosis, and scarring

we see the disappearance of rete pegs, thinning epidermis, and hyperkeratosis

S/S include thinned whitened epithelium-parchment like appearance, atrophy of labia, vaginal orifice contricted, not premalignant

tx: topical testosterone, progesterone, corticosteroid

Answer 2

lichen sclerosus

Question 3

this one affects women 30-60 yrs old

focal vulvar pruritis and gray white plaques from hyperplasia

morphology due to acanthosis, variable dermal leukocyte infiltration, nonspecific histologic changes

tx: corticosteroids

Answer 3

squamous hyperplasia (lichen simplex chronicus)

Question 4

what are the types of vulvar diseases?

Answer 4

vulvar dystrophies

vulvar neoplasia

Question 5

what are the types of vulvar neoplasias?

Answer 5

condyloma accuminatum

vulvar intraepithelial neplasia

vulvar squamous cell carcinoma

extramammary paget disease

malignant melanoma

Question 6

this neoplasia results in veneral warts due to HPV 6/11 (low risk); 16/18 high risk; sexually transmitted with the vulva less commonly involved than the cervix

morphology leads to
koilocytosis, acanthosis, verrucous gross appearance

can progress to VIN/SCC

tx: topical podophyllin or trichloroacetic acid

Answer 6

condyloma accuminatum

Question 7

this vulvar neoplasia is uncommon, 3% of all genital cancers in females

mostly squamous cancer, the rest are basal cell or adenocarcinoma

white/pigmented vulvar plaques, nuclear atypica, multicentric

can persist for years before becoming invasive carcinoma, increased rate of progression with > 45 y/o and immunosuppression

Answer 7

vulvar intraepithelial neoplasia

Question 8

this vulvar neoplasia is HPV/VIN associated which is poorly differentiated, non keratinizing

non-HPV associated, well differentiated

metastatic risk involves tumor size, depth of invasion, lymphatic involvment

clinical course with lesions < 2 cm in diameter with larger lesions with lymph node involvment

Answer 8

vulvar squamous cell carcinoma (SCC)

Question 9

this vulvar neoplasia is a rare lesion, arising from primitive epithelial progenitor cells

not assoc with underlying carcinoma

pruritic, red, well demarcated map like lesion

labia majora is the common site

Answer 9

extramammary paget disease

Question 10

we usually see this vulvar neoplasia in less than 5% of vulvar cancers

peak incidence at the 6th/7th decade with capable metastasis, overall poor prognosis

Answer 10

malignant melanoma