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Zoon Vulvitis — SCE Dermatology MCQ

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HardGenital DermatologyZoon VulvitisSCE Dermatology

A vulval biopsy from a well-defined shiny erythematous patch shows a dense band-like plasma-cell infiltrate without epithelial dysplasia. Which diagnosis best integrates the clinical and histological findings?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Vulvitis circumscripta plasmacellularis

The best answer is “Vulvitis circumscripta plasmacellularis”. The shiny red vulval plaque and dense plasma-cell-rich band support plasma-cell vulvitis. Histology is useful because erosive lichen planus, infection and differentiated neoplasia can produce overlapping symptoms but require different management. The alternatives “Erosive lichen planus with interface mucositis”, “Differentiated vulval intraepithelial neoplasia”, “Candidal vulvitis with fungal pseudohyphae”, “Extramammary Paget disease with pagetoid cells” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: BAD lichen sclerosus information: https://www.bad.org.uk/pils/lichen-sclerosus-in-females