Acantholytic dermatosis of the vagina: the diagnostic challenge of acantholytic disease in the genital region

Abstract

We report the case of a 24-year-old woman with an 8-month history of deep pelvic pain and postcoital bleeding. Examination revealed desquamation of the vaginal epithelium with tender fissured plaques in the vagina, initially thought to be vaginal intraepithelial neoplasia. Histology showed squamous mucosa with suprabasal acantholysis and hyperkeratosis, and no evidence of viral infection, dysplasia or malignancy. These findings were consistent with acantholytic dermatosis (AD), a rare lesion that resembles Hailey-Hailey and Darier disease histopathologically, but can be distinguished on a clinical basis. Vulval cases of AD are well recognized, but to our knowledge, this is the first reported case involving the vaginal epithelium alone.

Patients With LR-HPV Infection Have a Distinct Vaginal Microbiota in Comparison With Healthy Controls

“…The vagina is a unique and dynamic microecological system. When the type, quantity, distribution, and proportion of vaginal microbial population change significantly under the influence of external pathogenic factors, it may be manifested as an imbalance in the structure of microbial communities and further induce diseases (Gao et al, 2013; Gilliland et al, 2013; Kentley et al, 2017). There are not only symbiotic, but also antagonistic relationships among the vaginal microbiota.…”

Dermoscopic and reflectance confocal microscopic presentation of Hailey‐Hailey disease: A case series

“…Vegetating flexural lesions may be similar to those of pemphigus vegetans. [7][8][9] Histological examination of established HHD lesions reveals widespread acantholysis with suprabasilar vesicle or bulla formation. Acantholysis is typically incomplete with keratinocytes Although histopathology complemented by genetic testing are long considered gold standard for the diagnosis of HHD, emergent noninvasive techniques, including dermoscopy and reflectance confocal microscopy (RCM), may also play an important role.…”

“…Clinical differential diagnoses include candidiasis, inverse psoriasis, tinea corporis, allergic or irritant contact dermatitis, and Darier disease. Vegetating flexural lesions may be similar to those of pemphigus vegetans …”

Acantholytic Dermatosis of the Vulva: Case Series and Review of Literature

“…The common sites of occurrence are vulva, penis, scrotum, perianal area, and inguinal folds. A rare case involving vaginal epithelium has also been reported [2]. Clinical presentation ranges from solitary, discrete lesion to multiple grouped or confluent, flesh-colored papules, vesicles and bullae as well as white macerated patches and plaques [3].…”