Vulva Flashcards
The vulva is lined by what type of cell?
Squamous epithelium
Anatomical composition of vulva
skin and mucosa of the female genitalia external to the hymen (labia major, labia minor, mons pubis, and vestibule)
One BLANK is present on each side of the vaginal cancel and produces mucus-like fluid that drains via ducts into the lower vestibule
Barotholin galdn
what do you call cystic dilation of the Bartholin gland
bartholin cyst
what causes a bartholin cyst?
inflammation and obstruction of gland, usually in women of reproductive age
Bartholin cyst clinical presentation
presents as a unilateral, painful cystic lesion at the lower vestibule adjacent to the vaginal canal
warty neoplasm of vulvar skin, often large
condyloma
what is the most common cause of condylomas?
HPV types 6 or 11 (condyloma acuminatum)
less common cause of condylomas
Secondary syphilis (condyloma latum)
Histologically, HPV-associated condylomas are characterized by
koilocytes
risk of carcinoma with HPV 6 or 11
low-risk HPV rarely progresses to carcinoma
characterized by thinning of the epidermis and fibrosis (sclerosis) of the dermis; presents as a white patch (leukoplakia) with parchment-like vulvar skin
Lichen sclerosis
what is the typical population for lichen sclerosis?
postmenopausal women
likely etiology for lichen sclerosis
autoimmune
prognosis of lichen sclerosis
benign, but associated with a slightly increased risk for squamous cell carcinoma
Carcinoma arising from squamous epithelium lining the vulva
Vulvar carcinoma
Frequency of vulvar carcinoma
relatively rare, only a small percentage of female genital cancers
presentation of vulvar carcinoma
leukoplakia (biopsy may be required to distinguish from other causes of leukoplakia)
etiology of vulvar carcinoma
can be non-HPV or related to high risk HPV (16 or 18)
risk factors for vulvar carcinoma
related to HPV exposure
- multiple partners
- early first age of intercouse
- generally occurs in women of reproductive age
from what does vulvar carcinoma arise?
vulvar intraepithelial neoplasia (VIN)
describe VIN
a dysplastic precursor lesion characterized by koilocytic change, disordered cellular maturation, nuclear atypic, and increased mitotic activity
Non-HPV vulvar carcinoma arises most often from
long-standing lichen sclerosis; chronic inflammation and irritation eventually lead to carcinoma
non-HPV vulvar carcinoma is generally seen in what population?
elderly women (average age > 70)
characterized by malignant epithelial cells in the epidermis of the vulva
Extramammary Paget disease
clinical presentation of extramammary paget disease
erythematous, pruritic, ulcerated vulvar skin
unlike paget disease of the nipple, extramammary paget disease is
not associated with underlying carcinoma
have to distinguish extramammary paget from what?
melanoma
extramammary paget stains
PAS+, keratin+, S100-
melanoma stains
PAS-, keratin-, s100+
