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Images in Clinical Practice
ARTICLE IN PRESS
doi:
10.25259/IJDVL_476_2023

Plasma cell vulvitis: A rare vulvar dermatoses

Department of Dermatology, Venereology & Leprology, Jodhpur, India
Department of Pathology, AIIMS, Jodhpur, India
Corresponding author: Dr. Abhishek Bhardwaj, Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India. dr.abhishekbhardwaj@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Agrawal A, Kaur M, Bhardwaj A, Vedant D. Plasma cell vulvitis: A rare vulvar dermatoses. Indian J Dermatol Venereol Leprol doi: 10.25259/IJDVL_476_2023

A 49-year-old woman complained of a persistent reddish painful lesion over genitalia for the past 6 years associated with dyspareunia. There was no history of associated discharge or erosions/vesicles. Examination revealed a well-defined bright erythematous patch over the periurethral area [Figure 1a]. On palpation, the lesion was non-indurated and nontender. Histopathological examination showed spongiosis, lymphocytic exocytosis and band-like infiltrate comprising mainly of plasma cells with admixed lymphocytes and histiocytes. Several mildly dilated and congested capillaries were also seen [Figures 1b and 1c]. The patient was diagnosed as a case of plasma cell vulvitis. Topical mid-potency steroids were given once daily following which the lesion had significant improvement.

Figure 1a:
Bright red erythematous shiny patch over periurethral area
Figure 1b:
Acanthosis and band-like dense infiltrate (H&E, 40×)
Figure 1c:
Dense inflammatory infiltrate of plasma cells (H &E, 400×)

Plasma cell vulvitis, also known as Zoon’s vulvitis, is an extremely rare vulval dermatoses presenting as solitary asymptomatic or pruritic sharply defined erythematous shiny plaque with ‘lacquer paint’ appearance. 1 Common differentials include desquamative inflammatory vaginitis and erosive lichen planus. Desquamative inflammatory vaginitis presents clinically with white-yellow discharge and vaginal erythema in a confluent or petechial pattern along with the presence of papillary lymphocyte-predominant infiltrate. 2 We wish to emphasise the classical presentation of a rare dermatoses through this case report and the need to differentiate it from other similar entities.

Declaration of patient consent

Appropriate patient consent has been obtained.

Financial support and sponsorship

Nil.

Conflict of interest

There is no conflict of interest.

References

  1. , , , . Plasma cell vulvitis: A systematic review. Int J Womens Dermatol. 2021;7:756-62.
    [CrossRef] [PubMed] [PubMed Central] [Google Scholar]
  2. , , , , , , et al. Desquamative inflammatory vaginitis and plasma cell vulvitis represent a spectrum of hemorrhagic vestibulovaginitis. J Low Genit Tract Dis. 2022;26:60-7.
    [CrossRef] [PubMed] [PubMed Central] [Google Scholar]

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