REPORT OF A CASE
A 79-year-old white woman presented to the gynecology department complaining of pruritus and a burning sensation in the vulvar region. On examination, a well-demarcated erythematous patch over a 1-cm area on the clitoris and clitoral hood was observed, and mild edema was present (Fig 1). Biopsy specimens were obtained from the clitoris and clitoral hood (Figs 2 through 4). Subsequently, the patient was referred to the dermatology department for evaluation and treatment of the lesion.What is your diagnosis?
Vulvitis chronica plasmacellularis (Zoon's vulvitis).
Biopsy specimens from the clitoris and the clitoral hood showed a broad lichenoid band of a lymphoplasmocytic infiltrate (Fig 3). Focal attenuation of the epidermis was present. Evidence for atypia was absent.
Balanitis circumscripta plasmacellularis (Zoon's erythroplasia, Zoon's balanitis) is an uncommon genital lesion occurring predominantly on the glans and prepuce of uncircumcised elderly men. Similar lesions in women are rare and have been termed vulvitis chronica plasmacellularis.
McCreedy CA, Melski JW. Vulvar Erythema. Arch Dermatol. 1990;126(10):1355-1356. doi:10.1001/archderm.1990.01670340107020