Patologiske funn i biopser fra vulva
Table G-1. 2006 ISSVD classification of vulvar dermatoses: pathologic subsets and their clinical correlates (Table modified from the original)
| Name of finding | Definition | Common clinical correlates |
|---|---|---|
| Vesiculobullous pattern | Immune deposits in skin may be bands of IgG or IgA at the basement membrane zone, of IgG deposits on the cell surface of keratinocytes. | Bullous pemphigoid, Cicatricial pemphigoid, Pemphigoid gestationis, Pemphigus vulgaris, Pemphigo vegetans |
| Spongiosis | Intercellular edema between keratinocytes in the epidermis; keratinocytes may become elongated; often accompanied by exocytosis of lymphocytes and sometimes neutrophils or eosinophils. | Eczematous dermatitis (atopic, contact and allergic) |
| Lichenoid pattern | A band-like infiltrate of inflammatory cells (usually lymphocytes) in the superficial dermis, parallel to the epidermis. | Lichen sclerosus, Lichen planus |
| Granulomatous pattern | Granulomas are conglomerates of monocyte-derived histiocytes (macrophages); sometimes mixed with other inflammatory cells. Groups of these histiocytes may aggregate to form mulinucleated giant cells. Chronic granulomatous diseases are a genetically heterogeneous group of immunodeficiencies producing infectious and non-infectious disease in which phagocytic cells fail to kill organisms that they have engulfed because of defects in a system of enzymes that produce free radicals and other toxic small molecules. | Crohn disease, Melkersson-Rosenthal syndrome |
| Dermal sclerosis | Increased collagen with decreased numbers of fibroblasts causing thickening. | Lichen sclerosus |
| Acanthosis | Diffuse epidermal hyperplasia with increased thickness of the stratum spinosum. | Lichen simplex chronicus, Psoriasis, Reiter’s syndrome |
| Acantholytic pattern | Loss of cohesion between keratinocytes because of dissolution of intercellular connections; may cause an intraepithelial vesicle. Keratinocytes are rounded rather than elongated and lymphocytes do not migrate into the epidermis. | Hailey-Hailey disease, Darier/s disease, Acantholytic dermatosis of the vulvocrural area |