CLINICAL ANALYSIS OF EXTRAMAMMARY PAGET’S DISEASE OF VULVA

Paget'sdiseasewasfirstlydescribedbyJamesPagetin1874asabreastlesion.ItwasalsoseenatotherplacesandgenerallycalledextramammaryPagetsdisease,76%ofwhichwaspredominantlyfoundonthevulva[1].Pagetsdiseaseofthevulvaremainsarareconditionthataccountsforlessthan1%ofvulvarneoplasms[2].Thelesionusuallyappearsaseczemaandmaybemisdiagnosed.However,invasivediseaseoradenocarcinomamaybepresentwithPagetsdisease.Andrecurrenceishighaftertreatment.TheaimofthisstudywastoreviewcasesofPagetsdiseaseinourhospitalandanal…     

Photodynamic Therapy for Bowen's Disease of the Vulva Area

Bowen''s disease is a squamous cell carcinoma in situ and has the potential to progress to a squamous cell carcinoma. The authors treated two female patients (a 39-year-old and a 41-year-old) with Bowen''s disease in the vulva area using topical photodynamic therapy (PDT), involving the use of 5-aminolaevulinic acid and a light-emitting diode device. The light was administered at an intensity of 80 mW/cm² for a dose of 120 J/cm² biweekly for 6 cycles. The 39-year-old patient showed excellent clinical improvement, but the other patient achieved only a partial response. Even though one patient underwent a total excision 1 year later due to recurrence, both patients were satisfied with the cosmetic outcomes of this therapy and the partial improvement over time. The common side effect of PDT was a stinging sensation. PDT provides a relatively effective and useful alternative treatment for Bowen''s disease in the vulva area.     

Vulvar epithelioid sarcoma: A case report with literature review

ObjectiveTo report a case of vulvar epithelioid sarcoma, a rare type of tumor that has been reported in 37 cases in the English literature to date.Case reportWe report three cases of vulvar epithelioid sarcoma, proximal type. Wide excisions of the mass were performed with margins free of tumor in all three cases.ConclusionDue to its low incidence, there are no evidence-based diagnostic algorithms or published recommendations for treatment. Locoregional lymph node involvement, vascular invasion, tumor size larger than 2 cm, deep localization, presence of necrosis, and a high mitotic index are known as poor prognostic factors. Adjuvant radiotherapy is advisable in the presence of a high-grade tumor or positive margins. The beneficial effect of adjuvant chemotherapy is not well established. Treatment decisions should be made based on the individual case presentation and pathology evaluation.     

Angiofibroma celular de vulva: una entidad a investigar

Cellular angiofibroma of the vulva is a well-circumscribed tumor that occurs in men and women. This tumor has histological and immunohistochemical features that distinguish it from other vulvar tumors. The prognosis is good, although there is a risk of recurrence. We report the case of a woman with this diagnosis.     

Erosive vulval lichen planus—a diagnosis not to be missed: a clinical review

Lichen planus is one of the inflammatory dermatoses that have a predilection for the genital mucosa, and the erosive type is particularly important. This can also affect other mucosal sites and scarring may occur, leading to significant symptoms and an effect on quality of life for patients. There is often a delay before the correct diagnosis is made and appropriate treatment instituted. This clinical review covers the clinical features and management options for this important disease and emphasises the need for a multi-disciplinary approach.     

A rare case report of vulvar necrotizing fasciitis in a healthy patient

IntroductionNecrotizing fasciitis (NF), a necrotizing infection of the soft tissue, is a medical emergency usually occurring in the lower extremities and abdominal regions and often difficult to diagnose promptly.Presentation of caseThis case report looks at one atypical presentation of NF with the unusual location of the vulva and no known associated comorbidities or risk factors.DiscussionDiagnosing this patient was particularly difficult due to the inconsistent clinical, laboratory and imaging findings. The CT scans and WBC count were indicative of NF, but the LRINEC score was not high enough to make the diagnosis of NF. As a result, we relied on the hemodynamic instability and clinical findings of the physical exam to be strong indicators of NF, and acted on that indication.ConclusionActing quickly on the hemodynamic findings and suspicion as opposed to waiting for a confirmed diagnosis resulted in a good prognosis since immediate surgical debridement is imperative to surviving this acute condition. Despite major advancements in the imaging modalities and the introduction of a laboratory score, our case suggests that the diagnosis still heavily relies on clinical findings, such as hemodynamic instability. Furthermore, our case suggests that NF should be included in the differential regardless of atypical location and lack of common clinical associations.