PITFALL D efinition —A reactive condition marked by acanthosis and irregular epithelial architecture. Clinical Features Epidemiology Noncontributory. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

PITFALL D efinition —A papillosquamous lesion of significant size, histologically indistinguishable from generic condyloma. Clinical Features Epidemiology A rare entity that most commonly affects young men. Seen more commonly in immunosuppressed patients (human immunodeficiency virus [HIV] positive). Can also be seen in older women and may be human papillomavirus (HPV) negative. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited…

D efinition —A papillary exophytic squamous lesion similar in morphology to vulvar intraepithelial neoplasia (VIN) III but with risk of underlying invasion. Clinical Features Epidemiology Identical to that of a classic or usual high-grade VIN. May be associated with an invasive carcinoma. Human papillomavirus (HPV) positive, usually HPV 16. Predominating in the fifth and sixth decades of age. You’re Reading a Preview Become a Clinical Tree…

D efinition —Invasive epithelial neoplasm composed of keratinocytes involving the vulva. Exhibits a distinct histology and invasive pattern that is nonmetastasizing. Clinical Features Epidemiology Typically affects women in their seventh and eighth decades and is usually found associated with inflammatory dermatosis. May be associated with atypical verruciform hyperplasia. Human papillomavirus (HPV) negative and not linked to other gynecologic (cervical) squamous lesions. You’re Reading a Preview Become…

D efinition —Invasive epithelial neoplasm composed of keratinocytes involving the vulva. Human papillomavirus (HPV) negative. Clinical Features Epidemiology Typically affects women in their seventh and eighth decades and is usually found associated with inflammatory dermatosis (differentiated vulvar intraepithelial neoplasia [VIN]). Some patients present with no history of vulvar neoplasia. Not associated with HPV and not associated with squamous neoplasms of the cervix. You’re Reading a Preview…

D efinition —Invasive epithelial neoplasm composed of keratinocytes involving the vulva. Comprise tumors associated with classic vulvar intraepithelial neoplasia (VIN). Clinical Features Epidemiology Typically affects women in their sixth decade but can be seen in women under 40 who are immunocompromised. Strong association with human papillomavirus (HPV), particularly HPV 16. Usually found associated with classic VIN. Some patients present with no history of vulvar neoplasia. Strong…

D efinition —Invasion less than 2 cm in diameter and to a depth of less than 1 mm below the highest epithelial–stromal interface. Epidemiology A wide age range, from second to eighth decade, predominating in the fifth and sixth decades. Patients typically present with vulvar intraepithelial neoplasia (VIN). Approximately 20% of VINs in older women harbor areas of early invasion. You’re Reading a Preview Become a Clinical Tree…

D efinition —Vulvar acanthosis with altered differentiation (VAAD) is defined as vulvar acanthosis with variable verruciform architecture that lacks the nuclear atypia characteristic of vulvar intraepithelial neoplasia (VIN) but exhibits abnormalities in keratinocyte differentiation. It is classed as a risk factor for squamous carcinoma. For the purposes of this discussion, we will address this entity and potential mimics. Clinical Features Epidemiology Menopausal and postmenopausal women. Associated…

D efinition —A clinical and pathologic response to continued physical trauma comprised of markedly thickened skin with verruciform changes along with erythema and plaquelike scaling. Clinical Features Epidemiology Seen in all demographic groups; however, has been associated with vulvar cancer and verrucous carcinoma. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member.…

D efinition —Vulvar intraepithelial neoplasia (VIN) that likely is secondary to a series of host gene alterations that are discrete from those involved in classic VIN. Clinical Features Epidemiology Occurs in postmenopausal women but can be seen earlier. Associated with less than 5% of all diagnosed cases of VIN. Typically associated with chronic vulvar inflammatory disease (lichen sclerosus or lichen simplex chronicus). You’re Reading a Preview…

D efinition —A reactive epithelial process seen in skin or vulva characterized by a cytoskeletal defect with accumulation of nuclei in individual cells (multinucleation). Clinical Features Epidemiology No particular demographic other than an association with nonspecific, chronic, irritative, or inflammatory changes in the vulva. Similar changes can be seen in cutaneous dermatoses. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy…

PITFALL D efinition —A variant of epithelial atypia associated with gamma papillomaviruses, classically associated with epidermodysplasia verruciformis (EDV) but now appreciated in immunosuppressed (including human immunodeficiency virus [HIV]–infected) patients and involves the vulva. Clinical Features A wide age range. Multiple plaque or papular to verrucous in presentation, pigmented or nonpigmented. May resemble condyloma, seborrheic keratosis, or psoriasis. Increased frequency in HIV-infected or immunosuppressed women. Can be…

PITFALL D efinition —A rare variant of vulvar intraepithelial neoplasia (VIN) with lesional columnar (i.e., mucinous) cells. Clinical Features Epidemiology Rare, affects a small fraction of the patients with classic VIN. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

PITFALL D efinition —An unusual variant of vulvar intraepithelial neoplasia (VIN) in which the more poorly differentiated cells invade the overlying mature squamous epithelium. Clinical Features Epidemiology Rare, affects a small fraction of the patients with classic VIN. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition —Classic or “usual-type” vulvar intraepithelial neoplasia (VIN) with full-thickness atypia similar to that seen in bowenoid papulosis but with milder atypia. Clinical Features Epidemiology Consists of a fraction of the patients with classic VIN. May be seen in younger women. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log…

PITFALL D efinition —Human papillomavirus (HPV)-associated squamous intraepithelial lesion (SIL) with superimposed changes of lichen simplex chronicus (LSC). Clinical Features Epidemiology Affects a fraction of the patients with classic vulvar intraepithelial neoplasia (VIN). You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition —Classic (usual) high-grade squamous intraepithelial lesions of the vulva are defined as full-thickness or near full-thickness atypias associated with high-risk or carcinogenic human papillomavirus (HPV) infections, principally HPV 16. Clinical Features A wide age range, from second to eighth decade, predominating in the fourth and fifth decades. From papular to verrucous in presentation, pigmented or nonpigmented. Increased frequency in immunosuppressed women. Acetowhite in the…

D efinition —Flat condyloma is defined as a macular variant of condyloma that falls within the category of low-grade squamous intraepithelial lesion (LSIL) and displays an identical distribution of atypia as its exophytic counterpart. In contrast to exophytic condylomas, these flat lesions are more likely to be associated with high-risk human papillomavirus (HPV) types, although the majority do not contain HPV 16 and the regression rate…

PITFALL D efinition —An unusual variant of condyloma that is marked by a striking increase in apoptosis in the upper epithelial layers. Clinical Features Epidemiology Occurs in the same demographic groups as typical condyloma; however, disease is secondary to more uncommon variants of human papillomavirus (HPV) such as types 13 and 32. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy…

D efinition —A benign, warty proliferation of keratinocytes that is frequently pigmented and often associated with low-risk human papillomavirus (HPV) (types 6 and 11). Clinical Features Epidemiology Can be seen in all age groups. A large percentage are associated with HPV types 6 and 11, implying a variant of condyloma (or low-grade squamous intraepithelial lesion). Presumably a subset of HPV-negative lesions also exists. You’re Reading a…