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Nonneoplastic epithelial disorders of vulva

Nonneoplastic epithelial disorders of vulva. Women’s Hospital,School of Medicine Zhejiang University. General Considerations. Vulvar nonneoplastic epithelial disorders ：

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Nonneoplastic epithelial disorders of vulva

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  1. Nonneoplastic epithelial disorders of vulva Women’s Hospital,School of Medicine Zhejiang University

  2. General Considerations Vulvar nonneoplastic epithelial disorders ： a spectrum of chronic diseases represent abnormalities of pigmentation and degeneration in vulvar skin and mucosa. • previous name 1966: chronic vulvar dystrophy 1987:nonneoplastic epithelial disorders of skin and mucosa (ISSVD or ISGYP)

  3. Classification of skin diseases of vulva ▆Nonneoplastic epithelial disorders of skin and mucosa lichen sclerosus squamous hyperplasia other dermatoses ▆Intraepithelial neoplasia squamous intraepithelial neoplasia mild dysplasia moderate dysplasia severe dysplasia or carcinoma in situ nonsquamous intraepithelial neoplasia paget’s disease tumors of melanocytes, noninvasive ▆ Invasive tumors ISSVD 1987

  4. Lichen sclerosus of vulva Usually characterized by thinning and atrophy of vulvar skin or skin around the anus.

  5. Etiology unknown： • genetic • autoimmune disease • decrease or absence of estrogen and androgen

  6. Pathology • Epidermis: hyperkeratosis, epithelial atrophy, and flattening of the rete pegs; cytoplasmic vacuolization of the basal layer of cells • Upper dermis: edematous, pale-staining, acellular, homogenous collagen tissue • Deeper dermis: inflammatory infiltrate, mainly lymphocytic

  7. Clinic features ■symptoms • Intensive pruritus • dyspareunia • Burning sensation ■sign • Vulvar atrophy • Color changes: whitish

  8. Diagnosis • History & clinic symptoms • sign • Assistant examinations histological

  9. Treatment （1） general treatment drugs therapy physical therapy surgery

  10. Treatment （2） Local drug treatment effectiveness:80% recommend drug： 2% testosterone cream 0.3% progesterone cream 0.05% clobetasol

  11. Squamous cell hyperplasia of vulva • Squamous hyperplasia formerly: hyperplastic dystrophy characterized by benign hyperplasia of squamous epithelial cells with vulvar pruritus.

  12. unknown： Moist environment of vulva Repeatedly scratch Etiology

  13. Pathology • Epidermis: hyperkeratosis and acanthosis, producing thickening of the epithelium and elogation of the rete pegs • Dermis: no inflammatory infiltrate present

  14. Clinic features symptoms More intensive pruritus sign Epithelial thickening Color changes

  15. History & clinic symptoms sign Assistant examinations histological Diagnosis

  16. Treatment general treatment drugs therapy physical therapy surgery

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