A 51-year-old woman presented with a 6-month history of fatigue and a 5-month history of a sometimes painful and pruritic nonhealing nodule on her vulva that had not resolved despite electrodesiccation and oral antibiotic therapy. Physical examination showed an erythematous, ulcerated, 0.8-cm-diameter nodule on the right labium minus (Figure 1). Laboratory evaluation revealed the following results: hemoglobin, 80 g/L; platelets, 71.0 × 109/L; total peripheral white blood cells, 6.5 × 109/L, with 0.06 segmented neutrophils, 0.46 lymphocytes, 0.09 mononuclear cells, and 0.34 undifferentiated blast cells; serum VDRL test, nonreactive; and lactate dehydrogenase, 241 U/L. An excisional biopsy specimen of the nodule was obtained for histopathologic examination (Figure 2).
Schaller M, Heckmann M, Wörle B, Schirren CG. An Erythematous Nodule on the Vulva. Arch Dermatol. 1999;135(2):203-a-208. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-2-dof0299