Non-neoplastic Epithelial Disorders Of Vulva Research Articles

Focused Ultrasound Surgery Applications in Treating Vulvar Non-neoplastic Epithelial Disorders

: Vulvar intraepithelial neoplasia is a premalignant skin lesion of the vulva that often presents with severe vulvar pruritus, pain, and psychosexual disorders. The technology of non-invasive focused ultrasound surgery has improved over the years. Today its potential to treat these irritating diseases noninvasively is a relatively new area of clinical research interest. Increasing studies in China revealed that FUS treatment is effective and safe. This paper describes the preparation, technique, postoperative care, and results of this focused ultrasound surgery for treating vulvar non-neoplastic epithelial disease. Therefore it could be a future alternative treatment for benign vulvar diseases, replacing many invasive surgical treatments.

Prospective observational study of the efficacy of mixed methylene blue compound injection for treatment of vulvar non-neoplastic epithelial disorders.

To investigate the safety and efficacy of mixed methylene blue (MB) compound injection for treatment of vulvar non-neoplastic epithelial disorders (NNEDs). A prospective observational study among 118 women with vulvar NNEDs treated with intradermal injection of mixed MB compound at a hospital in Wuhan, China, between 2013 and 2016. Itching score, skin hypopigmentation area percentage (SHAP), and recurrence were assessed by interview and physical examination before and after treatment. Adverse effects were recorded. Before treatment, mean±SD itching score was 7.78±1.59. It decreased rapidly immediately after treatment and remained low thereafter (1.82±2.31, 1.69±2.39, 1.97±2.73, 2.05±2.72, and 2.19±2.86 at 1, 3, 6, 12, and 24months, respectively). Before treatment, mean±SD SHAP was 28.01%±18.28%. SHAP decreased gradually and remained stably low 6months later (26.28%±17.95%, 21.19%±18.42%, 19.19%±18.67%, 18.68%±18.91%, and 18.65%±19.20% at 1, 3, 6, 12, and 24months, respectively). The recurrence rate in 2years was 21.2% (25/118) with no major complications. Intradermal injection of mixed MB compound was found to be an effective and safe treatment for vulvar NNEDs. ClinicalTrials.gov: NCT03200808.

Differentiated vulvar intraepithelial neoplasia (dVIN): the most helpful histological features and the utility of cytokeratins 13 and 17

Differentiated vulvar intraepithelial neoplasia (dVIN) is the precursor lesion of HPV-negative vulvar squamous cell carcinoma (VSCC). The histopathological diagnosis of dVIN can be challenging, as it often resembles vulvar non-neoplastic epithelial disorders (NNED), especially lichen sclerosus (LS). We aimed to establish the most specific and reproducible histological features of dVIN and assessed cytokeratin 13 (CK13) and cytokeratin 17 (CK17) immunohistochemistry as a diagnostic aid. Consecutive cases of dVIN (n = 180) and LS (n = 105) from the period 2010 to 2013 were reviewed using a checklist of histological features. Each feature was recorded as ‘present’ or ‘absent’ and statistical comparison (dVIN vs LS) was made. Interobserver agreement between two pairs of pathologists was assessed for a subset of cases of dVIN (n = 31) and LS and other NNED (n = 23). Immunohistochemistry with CK13, CK17, MIB1 and p53 was performed on dVIN, LS, and other NNED cases. Macronucleoli, features of disturbed maturation and angulated nuclei were significantly more common in dVIN than LS (p < 0.001). We found ‘substantial agreement’ for the diagnosis of dVIN (κ = 0.71). Macronucleoli and deep keratinisation had the highest agreement. In dVIN, the mean percentage of cells staining with CK13 was 15 and with CK17, this was 74. For LS, the mean percentage of cells staining with CK13 was 31, and with CK17, this was 41. By plotting receiver operating characteristic curves (ROC), an area under the curve (AUC) of 0.52 was obtained for CK13, and an AUC of 0.87 was obtained for CK17. The most helpful histological features for diagnosing dVIN were macronucleoli, features of disturbed maturation, and angulated nuclei. Increased CK17 expression may have promise for supporting dVIN diagnosis.

Differentiated vulvar intraepithelial neoplasia (dVIN): Establishing the most helpful morphological parameters and evaluating the diagnostic usefulness of cytokeratin 13 and 17

Objective: Differentiated vulvar intraepithelial neoplasia (dVIN) is a challenging histopathological diagnosis because of its resemblance to vulvar non-neoplastic epithelial disorders (NNED), lichen sclerosus (LS) in particular. In this study the morphological features of dVIN to establish the most specific and reproducible features were quantified. To further add to the objectivity in dVIN diagnosis, combined immunohistochemistry with CK13 and CK17 was assessed.

Vulvar Cancer in China: Epidemiological Features and Risk Analysis

Objective: Describe for the first time the clinical, epidemiological features of vulvar cancer in southwest China. Identify risk factors and provide reference for the prevention of vulvar cancer. Method: We retrospectively analyzed 885 patients admitted to the West China Second University Hospital for vulvar diseases between 2006 and 2016. Vulvar cancer patients with previously diagnosed vulvar nonneoplastic epithelial disorders (n=132) were analyzed and compared to those without prior history of vulvar nonneoplastic epithelial disorders (n=219). Comparisons were also made among cancer patients and non-cancer patients with vulvar nonneoplastic epithelial disorders (n=288) and vulvar squamous intraepithelial lesions (n=246). The risk factors leading to vulvar cancer for the patients with vulvar nonneoplastic epithelial disorder were analyzed by univariate analysis. Furthermore, differences of the epidemiological features of vulvar nonneoplastic epithelial disorders, vulvar squamous intraepithelial lesion and vulvar cancer were identified. Results: According to the univariate analysis, age, first coital age, educational level, smoking, history of vaginal atrophy, HPV infection, lesion sites of the upper vulva and histo-pathological changes are strongly positively correlated with vulvar cancer. By comparing the features of vulvar cancer with those of the vulvar nonneoplastic epithelial disorder and vulvar squamous intraepithelial lesion, we found that on average patients with vulvar cancer had the highest age (ranged from 50 to 59), the lowest first coital age and the highest number of pregnancies and births. The incidences of vulvar nonneoplastic epithelial disorder and vulvar cancer were 1/1000 and 2.5/100,000 respectively with an increasing trend during last 10 years. Conclusion: Age, first coital age, educational level, smoking, atrophic vagina history, HPV infection, lesion sites of the upper vulva and histo-pathological changes are the risk factors that lead to vulvar cancer. Vulvar nonneoplastic epithelial disorder, vulvar squamous intraepithelial lesion and vulvar cancer each has distinct epidemiological features. Prompt surgical intervention and subsequent treatments are the key to a better outcome of vulvar cancer.

Efficacy of chlortetracycline treatment on vulvar non-neoplastic epithelial disorders

To observe the effectiveness of chlortetracycline (aureomycin) treatment on vulval white lesions and to explore its possible pathogenesis.From January 2001 to April 2011, 194 patients with vulvar non-neoplastic epithelial disorders were divided into three groups according to therapy regimens received, ie, chlortetracycline treatment group (72 cases), chlortetracycline + beclomethasone treatment group (66 cases), and beclomethasone treatment group (56 cases); their local changes of vulvar lesions were observed and efficacy of these treatment profiles was evaluated after one year.Effective rates of chlortetracycline group, chlortetracycline + clobetasol group and clobetasol groups were 86.1% (62/72), 87.9% (58/66), and 62.5% (35/56), respectively. There was a significant difference among these three groups (Hc = 10.7766,p = 0.0046), the curative rate of clobetasol group was markedly lower than that of the former two groups (p = 0.0072 and p = 0.0019), but was not statistical significant (p = 0.6077) when compared between the former groups.The occurrence of vulvar non-neoplastic epithelial disorders may be associated with chlamydia and mycoplasma infection, the chlortetracycline is an effective drug for this illness, the mechanism of which might be related to killing pathogens directly and inhibiting inflammatory mediators.

Study of ultrastructural changes of the non-neoplastic epithelial disorders of vulva after focused ultrasound treatment

Objective:This study was undertaken to investigate the ultrastructural changes of non-neoplastic epithelial disorders of the vulva (known as vulvar dystrophies) after focused ultrasound treatment and to assess the effectiveness of such treatment. Materials & methods: In total, 60 patients with non-neoplastic epithelial disorders of the vulva were enrolled in this study and treated by focused ultrasound therapy. Before and after treatment, changes to ultrastructures in the treatment region were evaluated using pathological and electron microscopic studies in 30 patients and the short-term treatment effectiveness was assessed. Results: Symptoms of the patients were greatly reduced or even eliminated. There was no itching or pain during sex. Lesions prior to treatment showed various degrees of hyperplastic atrophy and degenerative changes. At the same time, an increase in epithelial keratosic and decrease in melanotic granules and desmosomes was observed. Mitochondria with swelling and capillary contraction ...

ACOG educational bulletin: Vulvar nonneoplastic epithelial disorders

International Journal of Gynecology & ObstetricsVolume 60, Issue 2 p. 181-188 ACOG educational bulletin: Vulvar nonneoplastic epithelial disorders First published: 01 January 2017 https://doi.org/10.1016/S0020-7292(97)90227-7Citations: 6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume60, Issue2February 1998Pages 181-188 RelatedInformation

1175 The risk for malignant progression of vulvar non-neoplastic epithelial disorders: A prospective study

Vulvar Lichen Sclerosis (LS) and Squamous Cell Hyperplasia (SCH), known as ''vulvar non-neoplastic disorders", have a strong topographic association and co-existence with Squamous Cell Carcinoma of the vulva (SCCV). In the last 10 years, 156 patients (pts) with vulvar nonneoplastic epithelial disorders were referred to our Center. Eleven women were lost to follow-up and nine died of unrelated causes. Of the remaining 136 pts who were treated and followed, 14 (10.3%) progressed to SCCV. Of these 14, three had SCH, six had LS and five had mixed lesions. Three of these pts refused topical treatment and 11 did not respond to any topical preparation offered. All 14 were surgically treated and malignant recurrence was documented in nine (eight from the group that failed to respond to topical preparations and one from the group that refused topical treatment). This study suggests that pts who do not respond to conventional topical therapy should be regarded as being at high risk for malignant progression.

Significance of vulvar non-neoplastic epithelial disorders in etiology of vulvar cancer

Significance of vulvar non-neoplastic epithelial disorders in etiology of vulvar cancer

What Is the ISSVD Classification of Vulvar Nonneoplastic Epithelial Disorders and Intraepithelial Neoplasia?

What Is the ISSVD Classification of Vulvar Nonneoplastic Epithelial Disorders and Intraepithelial Neoplasia?