Vulvar Fordyce adenitis: A cohort of 45 women |
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| Institution: | 1. Department of Dermatology, CHU Rennes, 35033 Rennes cedex 9, France;2. Study group for anogenital diseases, French Society of Dermatology, Maison de la Dermatologie, 10, cité Malesherbes, 75009 Paris, France;3. Department of Pathology, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France;4. Department of Dermatology, Royal Liverpool University Hospitals, Prescot Street, Liverpool L7 8XP, United Kingdom;5. Private Vulvar Clinic, 4, rue Léon-Delhomme, 75015 Paris, France;1. Dermatology Department, Hôpital Archet, Centre Hospitalier Universitaire (CHU) de Nice, 06200 Nice, France;2. Dermatology Department, CHU de Rouen, Service d’allergologie, Centre Erik Satie, CHU, 76000 Rouen, France;3. Dermatology and Allergy Department, Hôpital Tenon, AP–HP, 75020 Paris, France;4. Dermatology Department, CHU Lille, University Lille, INFINITE U1286 Inserm, 59000 Lille, France;5. Dermatology Department, CHU de la Timone, 130005 Marseille, France;6. Paediatric Dermatology Department, Hôpital Pellegrin, CHU, 33300 Bordeaux, France;7. Dermatology Department, CHU de Besançon, 25000 Besançon, France;8. Dermatology Department, Hôpital Saint Eloi, CHU, 34090 Montpellier, France;1. Service de dermatologie, CHU de Lille, 59000 Lille, France;2. Inserm, U1286 – INFINITE – Institute for Translational Research in Inflammation, CHU de Lille, University Lille, 59000 Lille, France;3. ULR 2694 – METRICS: évaluation des technologies de santé et des pratiques médicales, CHU de Lille, University Lille, 59000 Lille, France;1. Institut de pathologie multisite, hospices civils de Lyon, hôpital Lyon Sud, 69310 Pierre-Bénite, France;2. Service de dermatologie, hospices civils de Lyon, hôpital Lyon Sud, 69310 Pierre-Bénite, France;3. Université Claude-Bernard, Lyon 01, 69100 Lyon, France;1. Department of Dermatology, Cochin Hospital, APHP and University of Paris, 27, rue Faubourg Saint-Jacques, 75679 Paris cedex 14, France;2. Department of Pathological Anatomy, Cochin Hospital, APHP and University of Paris, 27, rue Faubourg Saint-Jacques, 75679 Paris cedex 14, France;3. Nail Disease Center, 42, rue des Serbes, 06400 Cannes, France;4. Cabinet Mathurin Moreau Paris 19, 35, avenue Mathurin Moreau, 75019 Paris, France |
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| Abstract: | BackgroundRecurrent episodes of painful papules and nodules, mostly located on the labia minora, have been reported under the denominations of vulvar sebaceous adenitis (14 published cases) and vulvar acne (16 published cases).ObjectivesThe primary aim of this study was to delve further into the clinical and pathological features of this condition. The secondary aim was to collect therapeutic data.MethodsIn this retrospective cohort study, files and photographs of patients with papules or nodules on the labia minora or the inner labia majora were extracted from a vulvar clinic database. Clinical, pathological and therapeutic data were analysed.ResultsForty-five women were included from 2002 to 2018. The median age at the time of diagnosis was 36 years (range: 16–60). The median time to diagnosis was 6.5 years. Clinical features included recurrent painful papules, pustules or nodules, suppuration (n = 22), and pitted scars (n = 10) on the labia minora (n = 41), the inner labia majora (n = 19), the outer labia majora (n = 1), and the clitoral hood (n = 1). Associated acne vulgaris was seen in 17 out of 26 patients for whom data were available. Hidradenitis suppurativa, androgenic alopecia and hirsutism were observed in 3, 1 and 1 cases respectively. Neutrophilic infiltrates were observed in the 4 available biopsies within or around the Fordyce sebaceous glands in 2 patients. Treatment with tetracyclines and oral zinc was not consistently effective. Isotretinoin led to complete remission in 4 patients unresponsive to tetracyclines.DiscussionVulvar sebaceous adenitis/vulvar acne is a clinically identifiable cause of painful recurrent inflammatory lesions affecting the labia minora and the inner labia majora, which are coincidentally sites of Fordyce granules. We therefore suggest a more specific denomination: “vulvar Fordyce adenitis”. The relationship with acne vulgaris and hidradenitis suppurativa requires further investigation. We suggest use of an oral anti-acne therapeutic strategy to reduce inflammation and to decrease the secretion of the sebaceous glands. |
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| Keywords: | Fordyce gland Fordyce granule Sebaceous adenitis Acne Hidradenitis suppurativa |
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