Podcast
Questions and Answers
What anatomical structures are included in the definition of the vulva?
What anatomical structures are included in the definition of the vulva?
Which condition is characterized by a unilateral, painful cystic lesion adjacent to the vaginal canal?
Which condition is characterized by a unilateral, painful cystic lesion adjacent to the vaginal canal?
What is the hallmark histological feature of HPV-associated condylomas?
What is the hallmark histological feature of HPV-associated condylomas?
In which demographic is lichen sclerosis most commonly observed?
In which demographic is lichen sclerosis most commonly observed?
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What distinguishes lichen simplex chronicus from lichen sclerosis?
What distinguishes lichen simplex chronicus from lichen sclerosis?
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What type of HPV is most commonly associated with vulvar carcinoma?
What type of HPV is most commonly associated with vulvar carcinoma?
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What is a primary risk factor for the development of HPV-related vulvar carcinoma?
What is a primary risk factor for the development of HPV-related vulvar carcinoma?
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Which condition is considered benign but has a slightly increased risk for squamous cell carcinoma?
Which condition is considered benign but has a slightly increased risk for squamous cell carcinoma?
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Study Notes
Vulva Conditions
- Basic Principles: The vulva encompasses the external female genitalia, including the labia, clitoris, and vestibule, lined with squamous epithelium.
- Bartholin Cysts: These are cystic dilations of Bartholin glands, located on either side of the vaginal canal. They produce mucus and typically arise from inflammation and gland obstruction, often in reproductive-aged women. Present as unilateral, painful cysts near the vaginal canal.
- Condyloma: A wart-like vulvar skin growth, frequently large, typically caused by HPV types 6 or 11 (condyloma acuminatum). It's sexually transmitted. Microscopically, koilocytes (distinctive HPV-infected cells) are present. This condition rarely progresses to cancer.
- Lichen Sclerosis: Characterized by epidermal thinning and dermal fibrosis, presenting as a white, parchment-like vulvar patch. Common in postmenopausal women, though autoimmune factors may play a role. Slightly increased risk of squamous cell carcinoma.
- Lichen Simplex Chronicus: This condition involves vulvar squamous epithelium hyperplasia, often appearing as leukoplakia (white patches) related to chronic irritation or scratching. Benign, with no increased risk of squamous cell carcinoma.
- Vulvar Carcinoma: A cancer arising from the vulvar squamous epithelium. Relatively uncommon. Often presents as leukoplakia, requiring biopsy to differentiate from other causes. Etiology can be HPV-related (high-risk types 16 and 18) or non-HPV related.
Extramammary Paget Disease
- Characteristics: Maligned epithelial cells within the vulva epidermis, presenting as erythematous, itchy, ulcerated vulvar skin. Typically carcinoma in situ (no underlying cancer). Distinguished from other leukoplakic conditions via biopsy.
- Differentiating from Melanoma: Paget disease cells stain positive for PAS, keratin, and S100, while melanoma cells are PAS-, keratin-, and S100-. This characteristic distinguishes Paget disease from potential melanoma, which occasionally affects the vulva.
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Description
Explore various conditions affecting the vulva, including Bartholin cysts, condyloma, and lichen sclerosis. Understand the underlying principles, symptoms, and associated risks for these conditions. Essential for anyone studying female reproductive health.
