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Vulval Intraepithelial Neoplasia — SCE Dermatology MCQ

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HardGenital DermatologyVulval Intraepithelial NeoplasiaSCE Dermatology

A 72-year-old with vulval lichen sclerosus develops a solitary hyperkeratotic plaque. Biopsy shows basal atypia with premature keratinisation, aberrant p53 staining and no block-type p16 expression. What is the diagnosis?

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Correct answer: C — Differentiated vulval intraepithelial neoplasia

Differentiated vulval intraepithelial neoplasia arises in a chronic inflammatory background, is usually HPV independent and often shows an aberrant p53 pattern with absent block-type p16. It is easily under-recognised and carries a substantial, often rapid, risk of invasive squamous cell carcinoma.

Reference: https://academic.oup.com/bjd/pages/bad-guidelines