Vulva Flashcards
what structures are included in the vulva
- skin and mucosa that is external to hymen
- labia majora, labia minora, mons pubis, vestibule
what epithelium lines the vulva
squamous epithelium
What is Bartholin cyst
cystic dilation of Bartholin gland
Where is Bartholin gland located? What does it produce? and where does is drain
- each side of vaginal canal
- mucus-like fluid
- ducts into lower vestibule
what causes Bartholin cyst
inflammation and obstruction of gland
who usually gets Bartholin cyst
women of reproductive age
how does Bartholin cyst present clinically
unilateral, painful cyst
What is condyloma
watery neoplasm of vulvar skin
often large
What are common and less common causes of condyloma
common: HPV 6 or 11
less common: secondary syphilis ( condyloma latum)
Histologically, HPV-associated condylomas are characterized by what
Koilocytes
Do condylomas progress to carcioma
rarely (low risk HPV)
What is Lichen Sclerosis
thinning of epidermis and fibrosis (sclerosis) of dermis
clinical presentation of Lichen Sclerosis
white patch ( leukoplakia) with parchment-like vulvar skin
Lichen sclerosis is seen in who
postmenopausal women
Is lichen sclerosis benign or malignant
Benign
- slightly increased risk for squamous cell carcioma
What is lichen simplex chronicus
hyperplasia of vulvar squamous epithelium
how does lichen simplex chronicus present
leukoplakia with thick, leathery vulvar skin
is lichen simplex chronicus benign or malignant
benign
no increased risk of squamous cell carcinoma
what is vulvar carcinoma
carcinoma arising from squamous epithelium lining vulva
how does vulvar carcinoma present
leukoplakia
Etiology of vulvar carcinoma
HPV related or non HPV related
HPV related vulvar carcinoma is due to which strands of HPV
HPV 16 and 18
What are risk factors related to HPV exposure
multiple sex partners
early first age of intercourse
who does HPV usually occur in
women of reproductive age
HPV related vulvar carcinoma arises from what condition
vulvar intraepithelial neoplasia (VIN)
what is VIN- vulvar intraepithelial neoplasia
dysplastic precursor lesion
- kiolocytic change
- disordered cellular maturation
- nuclear atypia
- increased mitotic activity
non-HPV related vulvar carcinoma arises from what condition
long-standing lichen sclerosis
who usually gets non-HPV vulvar carcinoma
elderly women
what is extramammary paget disease
malignant epithelial cells in EPIDERMIS of vulva
how does extramammary paget disease clinically present
erythematous
pruritic
ulcerated vulvar skin
characterize paget disease of nipple
malignant epithelial cells in EPIDERMIS of nipple
what is the difference between paget disease of nipple and extramammary paget disease
nipple: associated with underlying carcinoma
extramammary: carcinoma in situ, no underlying carcinoma
what are biomarkers for extramammary paget cells (impt to distinguish from melanoma)
PAS+
Keratin +
S100-
What are biomarkers for Melanoma of vulva
PAS-
Keratin -
S100 +
