Abstract:Plasma cell vulvitis is a very rare inflammatory disorder of vulva, characterized by a bright-red mucosal lesion of significant chronicity, which may be symptomatic. Very few case studies of this condition are reported in literature. We describe one such classical patient, who presented with slight dyspareunia. The diagnosis was confirmed on histopathological examination. It is important for clinicians to accurately diagnose this alarming condition in time.
“…2 ). The condition may be asymptomatic but commonly presents with symptoms of burning, stinging, pruritus, and pain ( Bharatia et al., 2015 ). Fig.…”
Section: Introductionmentioning
confidence: 99%
“…Its etiology is unknown, but PCV has been reported to occur in patients with coexistent autoimmune conditions, suggesting an autoimmune etiology. Additionally, hormonal, infectious, and irritant factors have been implicated in the pathogenesis of PCV ( Bharatia et al., 2015 ; Celik et al., 2012 ). Histopathologic findings ( Figs.…”
Background
Plasma cell vulvitis (PCV) is an inflammatory vulvar dermatosis that is not well characterized. Diagnosis is often delayed, and the condition can be refractory to treatment. To date, there are no systematic reviews on this topic.
Objective
This study aimed to provide a systematic review of PCV, including epidemiologic, clinical, and histopathologic findings, as well as associated comorbidities and treatment options.
Methods
A primary literature search was conducted using the PubMed, Ovid Medline, Cochrane, and CINAHL databases.
Results
Fifty-three publications with 196 patients (mean age: 55.3 ± 14.5 years) were included. The majority of studies were case reports and case series. Common symptoms included burning/stinging (52%), dyspareunia (44%), and pruritus (41%). Common findings included erythema (84%), glistening/shiny appearance (29%), well-demarcated lesions (25%), and erosions (22%). Common anatomic sites were the labia minora (45%), introitus (31%), and periurethral (19%). Fifty-three percent of patients had a solitary lesion. Common histologic findings were a predominant plasma cell infiltrate (88%), presence of other inflammatory cells (55%), hemosiderin/siderophages (46%), and epidermal atrophy (43%). Topical corticosteroids (64%) and tacrolimus ointment (13%) were the most frequent treatment modalities. In most reports, previous treatments were tried, and there was a diagnostic delay.
Conclusion
PCV is likely underrecognized and should be considered in patients with erythema of the mucous and modified mucous membranes, symptoms of burning or stinging, and a predominant plasma cell infiltrate on histopathology. First-line therapy should begin with high-potency topical corticosteroids, with the most evidence for clobetasol 0.05% or tacrolimus 0.1% ointment. Prospective studies are needed to further characterize this condition and to develop treatment guidelines.
“…2 ). The condition may be asymptomatic but commonly presents with symptoms of burning, stinging, pruritus, and pain ( Bharatia et al., 2015 ). Fig.…”
Section: Introductionmentioning
confidence: 99%
“…Its etiology is unknown, but PCV has been reported to occur in patients with coexistent autoimmune conditions, suggesting an autoimmune etiology. Additionally, hormonal, infectious, and irritant factors have been implicated in the pathogenesis of PCV ( Bharatia et al., 2015 ; Celik et al., 2012 ). Histopathologic findings ( Figs.…”
Background
Plasma cell vulvitis (PCV) is an inflammatory vulvar dermatosis that is not well characterized. Diagnosis is often delayed, and the condition can be refractory to treatment. To date, there are no systematic reviews on this topic.
Objective
This study aimed to provide a systematic review of PCV, including epidemiologic, clinical, and histopathologic findings, as well as associated comorbidities and treatment options.
Methods
A primary literature search was conducted using the PubMed, Ovid Medline, Cochrane, and CINAHL databases.
Results
Fifty-three publications with 196 patients (mean age: 55.3 ± 14.5 years) were included. The majority of studies were case reports and case series. Common symptoms included burning/stinging (52%), dyspareunia (44%), and pruritus (41%). Common findings included erythema (84%), glistening/shiny appearance (29%), well-demarcated lesions (25%), and erosions (22%). Common anatomic sites were the labia minora (45%), introitus (31%), and periurethral (19%). Fifty-three percent of patients had a solitary lesion. Common histologic findings were a predominant plasma cell infiltrate (88%), presence of other inflammatory cells (55%), hemosiderin/siderophages (46%), and epidermal atrophy (43%). Topical corticosteroids (64%) and tacrolimus ointment (13%) were the most frequent treatment modalities. In most reports, previous treatments were tried, and there was a diagnostic delay.
Conclusion
PCV is likely underrecognized and should be considered in patients with erythema of the mucous and modified mucous membranes, symptoms of burning or stinging, and a predominant plasma cell infiltrate on histopathology. First-line therapy should begin with high-potency topical corticosteroids, with the most evidence for clobetasol 0.05% or tacrolimus 0.1% ointment. Prospective studies are needed to further characterize this condition and to develop treatment guidelines.
“…PCV most commonly occurs in the fifth to eighth decades of life. 1 , 2 Clinically, it presents as chronic red-brown or orange well-demarcated macules or patches that are 1-3 cm in diameter accompanied by erosions and cayenne pepper-colored spots. 1 , 2 PCV ranges from being asymptomatic to presenting with burning pain, dyspareunia, and pruritus.…”
Section: Introductionmentioning
confidence: 99%
“…While the etiology of PCV remains unclear, there are several potential causes, including hormonal, viral, irritant, and potentially autoimmune factors. 1 , 2 Histologically, the infiltrate of PCV is composed primarily of polyclonal plasma cells, but lozenge- or diamond-shaped keratinocytes, erythrocyte extravasation, and hemosiderin deposition may also be observed. The plasma cell infiltrate observed on tissue biopsy is sufficient for a diagnosis of PCV, when plasma cells compose ≥50% of the sample.…”
Section: Introductionmentioning
confidence: 99%
“…Current treatment options include strong topical corticosteroids, topical calcineurin inhibitors, topical immunomodulators, surgical excision, liquid nitrogen cryotherapy, carbon dioxide laser ablation, and the synthetic retinoid etretinate. 1 , 2 , 3 However, these treatments do not provide a consistently effective treatment response across patient trials.…”
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