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vulvar intraepithelial hyperplasia
Dysplastic or neoplastic changes in the vulvar squamous epithelium.
Epidemiology:
- most often occurs in postmenopausal women [2]
Clinical manifestations:
1) most patients are asymptomatic
2) pruritus is the most common symptom
3) well circumscribed rough, keratinized white lesions
4) red or hyperpigmented lesions may also be present
5) may be unifocal or multifocal
6) lesions are generally raised, but may be macular
7) vulvar macular erythema is one presentation
8) dysuria or pain on urination may result from contact of urine with the abnormal vulva (GRS9) [1]
Laboratory:
- biopsy confirms diagnosis
Management:
1) wide local excision
2) imiquimod 5% often effective in HPV-positive women
3) prognosis: rarely a precursor to invasive disease
General
intraepithelial neoplasia
vulvar dystrophy (vulvar disorder)
References
- Geriatrics Review Syllabus, American Geriatrics Society,
5th edition, 2002-2004
- Geriatric Review Syllabus, 7th edition
Parada JT et al (eds)
American Geriatrics Society, 2010
- Geriatric Review Syllabus, 8th edition (GRS8)
Durso SC and Sullivan GN (eds)
American Geriatrics Society, 2013
- Geriatric Review Syllabus, 9th edition (GRS9)
Medinal-Walpole A, Pacala JT, Porter JF (eds)
American Geriatrics Society, 2016
- Geriatrics at your Fingertips, 13th edition, 2011
Reuben DB et al (eds)
American Geriatric Society
- ACOG Committee Opinion No. 509: Management of vulvar
intraepithelial neoplasia.
Obstet Gynecol. 2011 Nov;118(5):1192-4
PMID: 22015906