Koža vulve se razlikuje od koze drugih regija po različitoj bakterijskoj flori I uslovima trenja. Dermatološke bolesti vulvarne kože i mukoze se dele u dve grupe. Prvu grupu čine dermatoze slične ekstravulvarnim dermatozama, a drugu čine dermatoze koje zahvataju predominantno vulvarnu regiju. Spečificne dermatoze vulve su kontaktni dermatitis, lichen planus, lichen sclerosus. Infektivne bolesti vulve se mogu preneti direktnim kontaktom. Prepoznavanje tipičnih mikroskopskih karakteristika pomaze u dijagnostici scabiesa, herpes virusne infekcije i molluscum contagiosuma. Humani papilloma virusi (HPV) su epiteliotropni virusi i mogu uzrokovati premalgnu i malignu transformatciju epitelnih ćelija. Sledeći kriterijumi kao što su virusne promene, klinički parametri i mikroskopski nalaz upućuju na postojanje dva puta u karcinogenezi skvamoznog karcinoma vulve i to HPV-zavisni put udružen sa Vulvarnom intraepitelialnom neoplazijom/VIN/ klasičnog tipa i ne -HPV sa VIN diferentovanog (simlex) tipa često udruženim sa lichen sclerosusom i/ili vulvarnom hiperplazijom.Invazivni planocelularni karcinom je najčešći karcinom vulve. Procena prognostičkih faktora je neophodna komponenta patohistoloskog izveštaja. Visoki gradus tumora, vaskularna invazija, veće dimenzije tumora i dubina invazije zaslužuju imunohistohemijsku analizu limfnih čvorova radi nalazenja metastaskih ćelija karcinoma. Extramamarna Pagetova bolest je retka. Može biti primarnog kožnog porekla ili udružena sa nekožnim tumorima gastrointestinalnog ili porekla mokraćne bešike. Imunohistohemijskla analiza je važna za odredjivanje primarnog porekla tumora.
Paget desease can be primary cutaneus vulvar disease,or associated with noncutaneous carcinoma gastrointenstinal origin or bladder carcinoma. Immunohistochemical analysis is very helpful to determine primary origin. Immunohistochemical finding in primary vulvar cutaneus Paget desease are CK7+, EMa+, CEa+, s100, Melana-, HMB45-. Immunohistochemical finding in pagetoid rectal adenocarcinoma are CK7-, CK20+, CEa+. Immunohistochemical finding in pagetoid transitional cell carcinoma are CK. CK. 2012;
2.
Barchino-Ortiz L, Suárez-Fernández R, Lázaro-Ochaita P.
3.
actas dermosifiliogr. 2012;(4):260–75.
4.
Schwartz Jl C, Ts. darier’s disease misdiagnosed as severe seborrheic dermatitis. Mil Med. 2011;(12):1457–9.
5.
Yasar S, Mumcuoglu C, Serdar Z. Gunes P. a case of lichen sclerosus et atrophicus accompanying bullous morphea. ann dermatol. 2011;(3):354–9.
6.
Sander B. Lichen sclerosus--a neglected disease. Ugeskr Laeger. 2005;(46):2951–4.
7.
Gaspard L, Laffitte E, Michaud M, Eicher N, Lacour O, Toutous-Trellu L, et al. rev Med suisse. 2006;(335):718–22.
8.
Giraldo P, Cursino K, Gonçalves, Eleutério J Jr G. Nodular vulvar herpes in an HIVpositive woman. Int j Gynaecol Obstet. 2009;(3):255.
9.
Lin H, Linn G, Liu C, Cj C, Kj Y. an immunocompromised woman with severe molluscum contagiosum that responded well to topical imiquimod: a case report and literature review. Low Genit Tract dis. 2010;(2):134–5.
10.
Horn L, Klostermann K, Hautmann S, Höhn Ak, Beckmann M, Mehlhorn G. HPV-associated alterations of the vulva and vagina. Morphology and molecular pathology. Pathologe. 201AD;(6):467–75.
11.
Alonso I, Fusté V, Del Pino M, Castillo P, Torné. Fusté Pet al. does human papillomavirus infection imply a different prognosis in vulvar squamous cell carcinoma? Gynecol Oncol. 2011;(3):509–14.
12.
Ordi M, Fusté V, Lloveras B, Del Pino M. HPV-negative vulvar intraepithelial neoplasia (VIN) with basaloid histologic pattern: an unrecognized variant of simplex (differentiated) VIN. am j surg Pathol. 2009;(11):1659–65.
13.
Santos M, Montagut C, Mellado B, García. Immunohistochemical staining for p16 and p53 in premalignant and malignant epithelial lesions of the vulva. Int j Gynecol Pathol. 2004;(3):206–14.
14.
Brustmann H, Hinterholzer, Brunner A. Iimmunohistochemical expression of survivin and γ-H2aX in vulvar intraepithelial neoplasia and low-stage squamous cell carcinoma. Int j Gynecol Pathol. 2011;(6):583–90.
15.
Petignat P, Gynecology C. rev Med suisse. 2010;(232):105–8.
16.
Woelber L, Choschzick M, Eulenburg C, Hager M, Gieseking F, F. Prognostic value of pathological resection margin distance in squamous cell cancer of the vulva. ann surg Oncol. 2011;(13):3811–8.
17.
Konidaris S, Bakas P, Gregoriou O, Kalampokas T. Kondi-Pafiti a. surgical management of invasive carcinoma of the vulva. a retrospective analysis and review. Eur j Gynaecol Oncol. 2011;(5):505–8.
18.
Vulval cancer: what is an adequate surgical margin? Eur j Gynaecol Oncol. 2008;(5):455–8.
19.
Brustmann H. Galectin-3 and Cd1a-positive dendritic cells are involved in the development of an invasive phenotype in vulvar squamous lesions. Int j Gynecol Pathol. 2006;(1):30–7.
20.
Shiomi T, Yoshida Y, Yamamoto K, Ito O, H. Extramammary Paget’s disease: evaluation of the histopathological patterns of Paget cell proliferation in the epidermis. j dermatol. 2011;(11):1054–7.
21.
Shan Sj, Zhang N, Sl G, Zhou Z, Chen X, Nie T. Guo Zet al Expression of survivin and human telomerase reverse transcriptase in extramammary Paget’s disease. Cutan Pathol. 2010;(6):635–40.
Citation
Copyright
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
