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Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura

Background: There is a broad spectrum of vulvar pigmented lesions that differ based on their histopathological and clinical features. Chronic vulvar purpura is a rare entity, associated with a broad morphological spectrum, from lichen aureus, Zoon’s vulvitis, pigmented purpuric dermatosis and with l...

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Autores principales: Luzar, Boštjan, Truden, Anamarija, Turk, Lara, Janša, Vid, Lewis, Fiona, Calonje, Eduardo, Smrkolj, Špela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964276/
https://www.ncbi.nlm.nih.gov/pubmed/36837408
http://dx.doi.org/10.3390/medicina59020206
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author Luzar, Boštjan
Truden, Anamarija
Turk, Lara
Janša, Vid
Lewis, Fiona
Calonje, Eduardo
Smrkolj, Špela
author_facet Luzar, Boštjan
Truden, Anamarija
Turk, Lara
Janša, Vid
Lewis, Fiona
Calonje, Eduardo
Smrkolj, Špela
author_sort Luzar, Boštjan
collection PubMed
description Background: There is a broad spectrum of vulvar pigmented lesions that differ based on their histopathological and clinical features. Chronic vulvar purpura is a rare entity, associated with a broad morphological spectrum, from lichen aureus, Zoon’s vulvitis, pigmented purpuric dermatosis and with lichen planus as in our case. Case presentation: In this article we discuss a case of an 86-year-old white woman with hyperpigmentation on her upper vulva, next to the introitus, with complaints of urine incontinence. Biopsy revealed subepithelial stromal lichenoid inflammatory infiltrate containing plasma cells, lymphocytes and some neutrophilic granulocytes as well as dilated and congested vessels. Hemosiderin deposits and erythrocyte extravasation were found. There was evidence of hyperkeratosis with hyper granulosis and erosions. Spongiosis was also noted. Few melanocytes were identified with no sign of malignancy. These findings correlate with the diagnosis of vulvar lichen planus. Conclusions: Chronic vulvar purpura is a clinical term used for different chronic inflammatory dermatoses presenting as red bluish or violaceous discolorations on the vulva, often associated with cayenne-pepper-like speckling. Considering a great overlap of possible diseases, the final diagnosis could be challenging. It is important to exclude a melanocytic tumour in these cases.
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spelling pubmed-99642762023-02-26 Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura Luzar, Boštjan Truden, Anamarija Turk, Lara Janša, Vid Lewis, Fiona Calonje, Eduardo Smrkolj, Špela Medicina (Kaunas) Case Report Background: There is a broad spectrum of vulvar pigmented lesions that differ based on their histopathological and clinical features. Chronic vulvar purpura is a rare entity, associated with a broad morphological spectrum, from lichen aureus, Zoon’s vulvitis, pigmented purpuric dermatosis and with lichen planus as in our case. Case presentation: In this article we discuss a case of an 86-year-old white woman with hyperpigmentation on her upper vulva, next to the introitus, with complaints of urine incontinence. Biopsy revealed subepithelial stromal lichenoid inflammatory infiltrate containing plasma cells, lymphocytes and some neutrophilic granulocytes as well as dilated and congested vessels. Hemosiderin deposits and erythrocyte extravasation were found. There was evidence of hyperkeratosis with hyper granulosis and erosions. Spongiosis was also noted. Few melanocytes were identified with no sign of malignancy. These findings correlate with the diagnosis of vulvar lichen planus. Conclusions: Chronic vulvar purpura is a clinical term used for different chronic inflammatory dermatoses presenting as red bluish or violaceous discolorations on the vulva, often associated with cayenne-pepper-like speckling. Considering a great overlap of possible diseases, the final diagnosis could be challenging. It is important to exclude a melanocytic tumour in these cases. MDPI 2023-01-20 /pmc/articles/PMC9964276/ /pubmed/36837408 http://dx.doi.org/10.3390/medicina59020206 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Luzar, Boštjan
Truden, Anamarija
Turk, Lara
Janša, Vid
Lewis, Fiona
Calonje, Eduardo
Smrkolj, Špela
Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura
title Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura
title_full Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura
title_fullStr Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura
title_full_unstemmed Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura
title_short Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura
title_sort vulvar lichen planus presenting as chronic vulvar purpura
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964276/
https://www.ncbi.nlm.nih.gov/pubmed/36837408
http://dx.doi.org/10.3390/medicina59020206
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