Vulvar pathology: Selected topics

Abstract

Skin of the vulva differs from the other sites from the different bacterial and friction features. Dermatologic diseases of vulvar skin and mucosa can be divided in two groups. The first includes dermatoses similar extravulvar sites, and second includes dermatoses affected predominantly vulvar region. Specific dermatoses of vulva are contact dermatitis, seborrhoic dermatitis, lichen planus, lichen sclerosus. Infectios deseases of vulva can be transmited by direct contact. Recognition of typical microscopic findings can helped for dignosis of scabies, herpes virus, molluscum contagiosum diseases of vulva. Human papilloma viruses (HPV) are epithelitrophic viruses and cause premalgnant and malignant transformation of epithelial cells.According criteria like viral associated changes,clinical paramethars, microscopic features there are two pathways in carcinogenesissquamous cell carcinoma HPVrelated pathway associated with Vulvar intraepithelial neoplasia/VIN of the classic type, and the non- HPV related with VIN of the differentiated (simlex) type frequently associated with lichen sclerosus and/or vulvar hyperplasia. Invasive squamous carcinoma is the most common carcinoma of vulva. Prognostic factors like stage, extracapsular nodal spread,infiltrative margins, vascular invasion, degree of differentiation, status of adjacent skin, stromal response, p53 overexpression are necessary for report. High tumor grade, capillary lymphatics invasion, biger tumor size and depth invasion deserve imunohistochemical analysis lymph nodes for metastatic cells of carcinoma. Extramammary Pagets desease is rare neoplasm. Paget desease can be primary cutaneus vulvar disease,or associated with noncutaneous carcinoma gastrointenstinal origin or bladder carcinoma. Immunohistochemical analysis is very helpful to determine primary origin.