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Vulvar lesion mimicking vitiligo: A case report

BACKGROUND: Post-inflammatory hypopigmentation (PIH) is an acquired partial or total loss of pigment that occurs as a result of cutaneous inflammation. Clinically, post-inflammatory hypopigmentation is recognized by a discoloration of the skin; however, proper diagnosis requires a skin biopsy. Altho...

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Autores principales: Gutierrez, Paula, Gandhi, Kushal, Amakiri, Nnana, Garza, John, Ventolini, Gary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7334793/
https://www.ncbi.nlm.nih.gov/pubmed/32642448
http://dx.doi.org/10.1016/j.crwh.2020.e00234
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author Gutierrez, Paula
Gandhi, Kushal
Amakiri, Nnana
Garza, John
Ventolini, Gary
author_facet Gutierrez, Paula
Gandhi, Kushal
Amakiri, Nnana
Garza, John
Ventolini, Gary
author_sort Gutierrez, Paula
collection PubMed
description BACKGROUND: Post-inflammatory hypopigmentation (PIH) is an acquired partial or total loss of pigment that occurs as a result of cutaneous inflammation. Clinically, post-inflammatory hypopigmentation is recognized by a discoloration of the skin; however, proper diagnosis requires a skin biopsy. Although post-inflammatory hypopigmentation is similar in appearance to vitiligo, histopathological evaluation highlights the key differences in the presence of melanocytes and melanophages. CASE PRESENTATION: A 28-year-old woman presented with discoloration in the vulvovaginal area. Physical examination was within normal limits; however, a genital exam revealed a large, intensely white discoloration in an hourglass pattern involving the clitoris, labia majora, and perianal area. Pigmentation was observed at the base of the hair follicles, which is not consistent with vitiligo. The patient consented to a skin biopsy, which was performed without complication. The biopsy showed mild chronic vulvitis and pigment incontinence due to post-inflammatory hypopigmentation. The patient was prescribed a high-potency topical steroid and a significant reduction in lesion area was observed at 3-month follow-up. DISCUSSION: Proper diagnosis via clinical examination and skin biopsy is essential in the treatment of pigment deficiencies. In cases of post-inflammatory hypopigmentation, the initial cause of inflammation must first be identified in order to provide an effective treatment regimen. When facing uncommon dermatological conditions such as post-inflammatory hypopigmentation, proper histopathological diagnosis, course of treatment, and follow-up are important in order to achieve patient satisfaction.
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spelling pubmed-73347932020-07-07 Vulvar lesion mimicking vitiligo: A case report Gutierrez, Paula Gandhi, Kushal Amakiri, Nnana Garza, John Ventolini, Gary Case Rep Womens Health Article BACKGROUND: Post-inflammatory hypopigmentation (PIH) is an acquired partial or total loss of pigment that occurs as a result of cutaneous inflammation. Clinically, post-inflammatory hypopigmentation is recognized by a discoloration of the skin; however, proper diagnosis requires a skin biopsy. Although post-inflammatory hypopigmentation is similar in appearance to vitiligo, histopathological evaluation highlights the key differences in the presence of melanocytes and melanophages. CASE PRESENTATION: A 28-year-old woman presented with discoloration in the vulvovaginal area. Physical examination was within normal limits; however, a genital exam revealed a large, intensely white discoloration in an hourglass pattern involving the clitoris, labia majora, and perianal area. Pigmentation was observed at the base of the hair follicles, which is not consistent with vitiligo. The patient consented to a skin biopsy, which was performed without complication. The biopsy showed mild chronic vulvitis and pigment incontinence due to post-inflammatory hypopigmentation. The patient was prescribed a high-potency topical steroid and a significant reduction in lesion area was observed at 3-month follow-up. DISCUSSION: Proper diagnosis via clinical examination and skin biopsy is essential in the treatment of pigment deficiencies. In cases of post-inflammatory hypopigmentation, the initial cause of inflammation must first be identified in order to provide an effective treatment regimen. When facing uncommon dermatological conditions such as post-inflammatory hypopigmentation, proper histopathological diagnosis, course of treatment, and follow-up are important in order to achieve patient satisfaction. Elsevier 2020-06-22 /pmc/articles/PMC7334793/ /pubmed/32642448 http://dx.doi.org/10.1016/j.crwh.2020.e00234 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Gutierrez, Paula
Gandhi, Kushal
Amakiri, Nnana
Garza, John
Ventolini, Gary
Vulvar lesion mimicking vitiligo: A case report
title Vulvar lesion mimicking vitiligo: A case report
title_full Vulvar lesion mimicking vitiligo: A case report
title_fullStr Vulvar lesion mimicking vitiligo: A case report
title_full_unstemmed Vulvar lesion mimicking vitiligo: A case report
title_short Vulvar lesion mimicking vitiligo: A case report
title_sort vulvar lesion mimicking vitiligo: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7334793/
https://www.ncbi.nlm.nih.gov/pubmed/32642448
http://dx.doi.org/10.1016/j.crwh.2020.e00234
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