Vulvar puritus for one year.
A 60-year-old menopausal female presented with vulvar itching for one year. She had noticed a whitish lesion on the vulva that slowly increased in size over the year. She had been unsuccessfully treated with oral fluconazole and topical clotrimazole-mometasone combinations and the plaque had gradually spread to involve the clitoris and peri-urethral area. She was neither diabetic nor hypertensive and had no other systemic complaints. Examination revealed a well-defined non-tender whitish plaque situated on her left labia minora and clitoris (Figure 1). A swab from the plaque did not grow any organism. Routine blood chemistry including a VDRL and HIV ELIZA were within normal limits. A punch biopsy from the lesion was taken and histopathology findings were as seen in (Figures 2 and 3).
P D Hinduja National Hospital, Mumbai, Maharashtra, India.
Nina A
NA
Madnani
Ashwini
A
Bhalerao-Gandhi
Kaleem J
KJ
Khan
D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D000077271:Imiquimod; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D011539:Pruritus Vulvae / Q000209:etiology* / Q000473:pathology*; D014622:Vaginal Creams, Foams, and Jellies; D014846:Vulvar Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*
D000634:Aminoquinolines; D000970:Antineoplastic Agents; D014622:Vaginal Creams, Foams, and Jellies; D000077271:Imiquimod