Ulcerating rheumatoid nodule of the vulva.
A case of an ulcerating rheumatoid nodule of the vulva in a 76 year old woman with rheumatoid arthritis complicated by Felty's syndrome is reported. The patient presented with a mass in the vulval region. On clinical examination, she had an ulcerated mass associated with inguinal lymphadenopathy. These findings resulted in a clinical diagnosis of invasive carcinoma of the vulva and an excision biopsy was carried out. On microscopic examination, the lesion showed the characteristic features of a rheumatoid nodule with ulceration of overlying epidermis. Adjacent vessels showed inflammation and fibrinoid necrosis of their walls suggestive of a vasculitis. Awareness of the possibility of ulceration in rheumatoid nodules may facilitate diagnosis and avert unduly aggressive treatment.
Appleton
M A
MA
Department of Pathology, University of Wales College of Medicine, Cardiff.
Ismail
S M
SM
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D012218:Rheumatoid Nodule / Q000473:pathology*; D014456:Ulcer / Q000473:pathology; D014845:Vulvar Diseases / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000175:diagnosis