A biopsy specimen obtained from a vulvar papule showed an adnexal tumor in the papillary and upper reticular dermis, without connection to the overlying epidermis (Figure 3). The tumor was formed by collections of epithelial cells arranged into cords separated by thickened dermal collagen bundles or forming small cystic structures containing amorphous material. A few of the cysts had a characteristic commalike appearance. There was no cytological atypia or trichilemmal differentiation, and mitoses were not seen. Additional sections evaluated immunohistochemically were negative for estrogen receptors (ERs) and progesterone receptors (PRs). Vulvar lesions were treated with electrodesiccation, with a modest improvement in appearance.
Neck and Vulvar Papules in an 8-Year-Old Girl. Arch Dermatol. 1999;135(2):203–208. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-2-dof0299
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