Distinguishing Erosive Lichen Planus From Differentiated Vulvar Intraepithelial Neoplasia

Journal of Lower Genital Tract Disease
Tania DayJames Scurry

Abstract

Erosive lichen planus (LP) and differentiated vulvar intraepithelial neoplasia (dVIN) may display overlapping histopathologic features. We searched the local pathology database for vulvar biopsies reported as dVIN or erosive vulvitis during 2011 to 2013 inclusive. After review of patient notes and slides, there were 5 cases with a clinical appearance and course consistent with erosive LP and histopathology showing epithelial regeneration. We then selected 5 cases of dVIN in which the clinical course and histopathology supported the diagnosis. We performed immunohistochemistry for p16 and p53 on all cases and did copy variant analysis on 1 case each of erosive LP and dVIN. Histopathology of the LP cases showed epithelial thinning, absent stratum corneum, lack of maturation, as well as nuclear changes of enlargement, pleomorphism, and hyperchromasia. Three LP cases (60%) showed a wild-type p53 pattern and 2 (40%) were confluent positive. Two dVIN cases (40%) showed full-thickness loss of differentiation. One case (20%) of dVIN was p53 negative, 2 (40%) were wild-type, 1 was confluent positive, and 1 showed dark suprabasilar staining. All cases were negative for p16. Compared with control, erosive LP epithelium showed a similar co...Continue Reading

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Citations

Apr 4, 2017·Journal of Lower Genital Tract Disease·Tania DayJames Scurry
Dec 23, 2017·Journal of Lower Genital Tract Disease·Tania DayJames Scurry
Feb 23, 2018·Journal of Lower Genital Tract Disease·Tania DayJames Scurry
Jul 12, 2018·Journal of Lower Genital Tract Disease·Tania DayJames Scurry
Apr 24, 2020·Journal of Lower Genital Tract Disease·Angela LinJames Scurry
Jun 25, 2020·The Australasian Journal of Dermatology·Ashod Kherlopian, Gayle Fischer
Sep 26, 2020·Journal of Lower Genital Tract Disease·Tania DayJames Scurry
Jun 28, 2017·Advances in Anatomic Pathology·Marc R LewinMaria A Selim
Mar 25, 2020·Journal of Lower Genital Tract Disease·Tania DayUNKNOWN ISSVD Difficult Pathologic Diagnoses Committee*
Oct 27, 2020·Journal of Lower Genital Tract Disease·Debra S HellerUNKNOWN ISSVD Difficult Pathologic Diagnoses Committee
Nov 21, 2020·Journal of Lower Genital Tract Disease·Joana LyraPedro Vieira-Baptista
Aug 21, 2020·Journal of Gynecology Obstetrics and Human Reproduction·Pedro Vieira-BaptistaJacob Bornstein

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