Vulvar erythema. Vulvitis chronica plasmacellularis (Zoon's vulvitis).
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Adult↗
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[Chronic granulomatous vulvitis (Melkersson-Rosenthal vulvitis)].
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Aged↗
Vulvitis plasmacellularis: two new cases.
Vulvitis chronica plasmacellularis or Zoon's vulvitis is a rare benign circumscribed inflammation of the vulvar mucosa. It is found in women ranging in age from 26 to 70 years. Shiny, macular erythematous lesions, which are irregular in shape and sharply marginated are usually observed. The histologic findings show chronic subepithelial dense inflammation composed largely of plasma cells. We here report two cases of vulvitis plasmacellularis with typical clinical manifestations, courses and histopathologic findings.
Adrenal Cortex Hormones↗
Isolation of Ureaplasma from bovine granular vulvitis.
Cultures for mycoplasmatales, viruses and bacteria were made from bovine vulvar swabs to determine whether ureaplasma was associated with a clinical granular vulvitis observed in 16 Ontario dairy herds. Ureaplasma was isolated from 23.5% of 34 clinically normal cows, 74% of 27 cows with mild to moderate vulvar hyperemia but no discharge and 100% of 20 cows with acute vulvar hyperemia accompanied by purulent discharge. There were statistically significant differences in rates of isolation among clinical groups. Mycoplasma bovigenitalium was isolated from 7.7% and 20% of cows with moderate or acute vulvitis respectively but not from normal cows. Haemophilus somnus was isolated from 25% of cows with acute vulvitis. There were no significant differences in isolations of Escherichia coli, Corynebacterium pyogenes and alpha-hemolytic streptococcus between normal and clinically affected animals. Cultures of 135 repeat samples from 33 cows revealed that ureaplasma persisted in some animals for at least three months. No viruses were isolated from any of the animals in this study.
Animals↗
Experimental bovine genital ureaplasmosis. II. Granular vulvitis, endometritis and salpingitis following uterine inoculation.
Twenty-three virgin Holstein heifers received uterine inoculations with ureaplasma and were necropsied one to thirteen days later. Three heifers inoculated intracervically were necropsied on days 3, 5 and 11.Granular vulvitis was produced on average by 3.6 days in fourteen of sixteen uterine inoculated heifers monitored for four or more days. Two cervically inoculated heifers monitored for over four days also developed granular vulvitis by the fourth day. At necropsy, ureaplasma was recovered from 94% of uterine horn cultures for the first four days postinoculation and 50% during days 5 to 7. Thereafter all uterine cultures were negative. The percentage of positive ureaplasma recoveries from uterine tube flushings was lower than for uterine horns but remained positive for a longer period. By day 7, three of four uterine tube flushings were still positive. No bacterial pathogens were isolated from the uterine horns or uterine tube flushings. On histopathology 50% of uterine inoculated heifers had endometritis up to six days postinoculation and a slightly higher percentage (58%) had salpingitis. Endometritis was not found in any heifers after day 6. Residual salpingitis was present in one heifer on day 7. Endometritis was present in cervically inoculated heifers necropsied on days 3 and 5 but not on day 11. Salpingitis was not found in any of the three cervically inoculated animals. The study concluded that some strains of ureaplasma are pathogenic for the upper reproductive tract of the cow and should be considered significant when isolated from cases of granular vulvitis, endometritis or salpingitis.
Animals↗
Experimental reproduction of ovine vulvitis with bacteria of the haemophilus/histophilus group.
Ovine vulvitis was experimentally reproduced by intravaginal inoculation of a mixture of bacterial strains of the histophilus/haemophilus group isolated from field cases. Grossly, the experimental vulvitis was identical to the field condition, and bacteria indistinguishable from the inoculated strains were reisolated.
Animals↗
Vulvitis circumscripta plasmacellularis treated successfully with interferon alpha.
A 74-year-old woman with vulvitis circumscripta plasmacellularis was successfully treated with intralesional injections of interferon alpha. Although the patient had been previously treated unsuccessfully for 5 years with topical administration of a potent corticosteroid, with cryotherapy, and with surgical procedures, the disease continually recurred. A course of interferon alpha resulted in a significant clinical improvement of the lesions, a histologically verified decrease of plasma cell infiltrate, and the disappearance of the antigen of herpes simplex virus that had been detected before treatment by direct immunofluorescence staining of the lesion. This clinical course demonstrates the effectiveness of local injections of interferon alpha into those lesions with vulvitis circumscripta plasmacellularis that did not previously respond to conventional therapy. Therefore an implication exists that herpes simplex virus infection may be one of the factors involved in the pathogenesis of this disease.
Aged↗
Ulcerative vulvitis in Reiter's syndrome. A case report.
In a case of acute Reiter's syndrome with severe vulvitis the diagnosis was based on the presence of a vaginal discharge and dysuria, arthritis, conjunctivitis, buccal ulceration, keratodermia blenorrhagica, and HLA B27 tissue-typing antigen. The vulval lesions were similar in appearance to those of circinate vulvitis. The acute histological change were confined to shallow ulceration with an inflammatory infiltration of the subjacent dermis. Coincidential lichen sclerosus et atrophicus was present, which could have been masked by the acute lesions.
Adult↗
[Vulvitis in young girls: value of cleansing base with concentrated colloidal oat extract].
Vulvitis is a frequent infection in young girls. Fourty prepubertal children with recurrent vulvitis were submitted, besides usual local hygiene rules, to a twice daily toilet with a cleansing base containing colloidal oat extract (Emulave fluid). It was associated with a colouring product in case of severe local inflammation during the first days of treatment. Minimal duration of the treatment was 15 days. In cases of long-term use, exceeding 3 months, no recurrence of local infection was observed. In all cases, tolerance was excellent.
Child↗
Two urogenital sinus syndromes. Interstitial cystitis and focal vulvitis.
Forty-six young women had unusual and presumably noninfectious disorders of unknown etiology involving tissues derived from the embryonic urogenital sinus (urogenital sinus syndromes). Ten women had interstitial cystitis, and 25 had focal vulvitis. Eleven women had both interstitial cystitis and focal vulvitis. The affected groups were similar in demographic and other characteristics. Most were white and in their mid-20s. Both unusual conditions occurred in the same woman more often than could be expected by chance. This observation suggests that some common, perhaps autoimmune mechanism may be involved in the etiology of these syndromes.
Adolescent↗
[Chronic pseudo-erythroplasic balanitis and vulvitis: histological study (author's transl)].
A case of pseudoerythroplasic vulvitis with histological features similar to purpuric telangiectasic and lichenoid balanitis is reported. The plasma cell infiltrate is usually discrete in these cases of chronic pseudoerythroplasic vulvitis and balanitis (CPVB). The authors suggest that these GPVB and Zoon's balanitis may represent different stages in the course of a same pathological process.
Adult↗
Experimental bovine genital ureaplasmosis. I. Granular vulvitis following vulvar inoculation.
Granular vulvitis was reproduced in ten virgin heifers following vulvar inoculation with strains of ureaplasma previously isolated from natural cases. The disease appeared one to three days postinoculation and was characterized by vulvar swabs but not from the upper mucopurulent discharge. At necropsy 13 to 41 days later, ureaplasmas were recovered consistently from vulvar swabs but not from the upper reproductive tract. It was concluded that some strains of ureaplasma are pathogenic and should be viewed as a cause of bovine granular vulvitis.
Animals↗
Focal vulvitis: a characteristic syndrome and cause of dyspareunia. Features, natural history, and management.
Based on the study of 67 affected women during a period of 15 years, we report the clinical features and natural history of focal vulvitis, a unique syndrome characterized by severe and persistent superficial dyspareunia and the presence of one to 11 (median three) minute, exquisitely tender areas of focal inflammation or ulceration on the mucosa of the vestibule. Three fourths of all lesions occur around the Bartholin gland ducts or between them posteriorly. Histopathologic study of tissues from seven patients has not shown a characteristic pattern of inflammation and fails to confirm a reported association between these lesions and the minor vestibular glands. These histologic studies and an in-depth clinical and epidemiologic investigation in nine patients, including microbiologic studies to identify infection by herpes simplex virus. Neisseria gonorrhoeae, Staphylococcus aureus, beta-hemolytic streptococci, Chlamydia trachomatis, mycoplasmas, Candida sp., trichomonads, or Mycobacterium sp., have not established an infectious etiology for this syndrome or evidence that it represents an unusual form of an autoimmune disease or Behcet's syndrome. Treatment with topical antimicrobial or corticosteroid creams, antibiotics given systemically, or cryotherapy has not been of demonstrable benefit. Approximately one half of patients eventually experience spontaneous remission but many appear to remain symptomatic indefinitely. Surgical excision of the hymenal ring and contiguous mucosa of the vestibule has brought relief and permitted resumption of sexual activity in seven of eight treated patients. While promising, operation should be reserved for patients who have experienced unremitting dyspareunia associated with the characteristic focal inflammatory lesions for at least 6 months.
Adolescent↗
Squamous cell carcinoma arising in a case of vulvitis granulomatosa or vulval variant of Melkersson-Rosenthal syndrome.
A case of vulvitis granulomatosa or the vulval variant of Melkersson-Rosenthal syndrome (MRS) in a young adult patient with systemic lupus erythematosus is presented. She also had evidence of cervicovulvovaginal human papilloma virus (HPV) infection. Nine years later she developed a squamous cell carcinoma (SCC) of the vulva. HPV 6/11 was found by DNA in situ hybridization within a vulval condyloma as well as within the carcinoma. This case is unusual in that SCC associated with HPV 6/11 developed in her vulva affected by MRS rather than in the cervix, where SCC was more likely to occur considering this patient's age.
Adult↗
Vulvitis circumscripta plasmacellularis.
In this paper we present what is apparently the tenth published case of vulvitis circumscripta plasmacellularis (Zoon). The patient had eroded, red-brown, asymptomatic vulvar lesions that were recalcitrant to treatment. The characteristic histopathology--dense plasma cell infiltrate and deposition of hemosiderin--was present.
Adult↗
Circinate vulvitis in Reiter's syndrome.
Two cases of Reiter's syndrome in women are described. The diagnosis was based on the presence of increased vaginal and cervical discharge containing excess leucocytes, arthritis, conjunctivitis, and HLA B27 tissue-typing antigen. In addition circinate lesions developed on the vulva similar to those seen on the glans penis. No previous description of these lesions has been traced and the name 'circinate vulvitis' is suggested for these lesions.
Adult↗
Vulvitis granulomatosa and anoperineitis granulomatosa.
We present the case of a 77-year-old female with a rare genital and anoperineal granulomatous cutaneous manifestation resembling cheilitis granulomatosa Miescher. The typical histological findings of epithelioid cell granulomas were localized in the vulva and anoperineal region; the latter manifestation has not yet been described. Based on our personal observations and a review of the literature, the clinical and histological features of vulvitis granulomatosa are described.
Aged↗
[Monosymptomatic Melkersson-Rosenthal syndrome with subsequent vulvitis and perivulvitis granulomatosa].
We report on an 40-year-old woman with granulomatous facial swelling followed by vulvitis and perivulvitis granulomatosa. The characteristic histopathology with epitheloid cell granulomas was seen in samples from both the face and the vulva. By immunohistochemistry the lesions were characterized as consisting mainly of histiocytic and CD-30-positive T cells. The possible aetiology is discussed briefly.
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