This paper discusses the clinicopathological characteristics of plasma cell vulvitis,and analyzes the clinical manifestations,histopathological features and immunophenotype of 1 patient with plasma cell vulvitis.It presented with vulvar itching for several years,vulvar pain aggravated in the last six months,and dermatologic examination showed thin vulvar skin,vesicles,adhesions in some areas,and hyperplasia and whitening of the hymenal margin.Under the microscope,some areas of squamous epithelium were seen to be degenerated,necrotic and detached,with a large number of small to medium-sized lymphoid cells and plasma cells infiltrating in bands within the dermis.Immunohistochemical results showed that CD3 positivity and CD20 positivity indicated that T lymphocytes and B lymphocytes were dominant near the epidermis,and polyclonal proliferating plasma cells could be seen underneath them,with the proportion of plasma cells>50%and Ki67 proliferation index<5%,diagnosing plasma cell vulvitis.Plasma cell vulvitis is less common,often occurs in postmenopausal women,and is easily misdiagnosed and needs to be differentiated from lichen planus,lichen sclerosus et atrophicus,fixed drug eruption,mucosal pemphigoid,plasmacytoma,Behcet syndrome,lymphomas,and immunoglobulin(IgG)4-associated lesions.It is often manifested as vulvar erosion,which is an inflammatory reaction dominated by plasma cell invasion.Immunohistochemical staining of CD20,CD38,CD3,immunoglobulin light-chain kappa(κ)and immunoglobulin light-chain lambda(λ)can help the diagnosis.Appropriate anti-inflammatory,red light and glucocorticoid treatments can achieve a satisfactory short-term outcome,and the long-term effect requires continued follow-up observation.
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