Study of melanocyte density and epidermal thickness in vulvar lichen sclerosus lesions

Abstract

Objective This study aimed to analyze changes in melanocyte density and epidermal thickness in vulvar lichen sclerosus (VLS). Methods Vulvar skin tissues were collected from 15 VLS female patients in Beijing Hospital, classified into early (n = 7) and late VLS (n = 8) groups according to pathological manifestations. Melanocyte density and full epidermal and cell‐layer (from the bottom of the stratum corneum to that of the basal layer) thickness were calculated using an image analysis software. The control group was normal vulvar skin tissues from 15 females after plastic surgery. Results The early VLS (0.170 ± 0.071 µm) and late VLS (0.110 ± 0.035 µm) groups had significantly lower densities of epidermal melanocytes than the control group (0.275 ± 0.036) (F = 36.426, P < 0.001). The cell‐layer thickness did not differ between the early VLS (154.603 ± 121.984 µm) and control (176.974 ± 80.296 µm) groups (P = 0.899) but significantly decreased in the late VLS group (83.455 ± 37.129 µm) compared to the control group (P = 0.003). Conclusions Melanocyte density decreased in early and late VLS. The full epidermal and cell‐layer thickness did not significantly change in early VLS, but the cell‐layer thickness decreased in late VLS.

A Scoping Review and Population Study Regarding Prevalence and Histopathology of Juvenile Vulvar Melanocytic Lesions. A Recommendation

“…(1998) Brenn, 2018 Differentiating various nevi from melanoma Narrative 0 n.s. Systematic description of differences in various types of nevi from melanoma Christensen et al., 1987 Comparison of histology of vulvar nevi to non-vulvar nevi Case series/case controlled 57 vulvar compared (2 aged ≤19) with 200 torso nevi (all aged ≥20) No No evidence found for increased risk of precursors to melanoma in vulvar nevi Clark et al., 1998 Histopathology of AMNGT, MM, DN Case series 56, of which 36 are AGN No Revisions of diagnosed melanocytic lesions, MVM genital, seminal publication, gives criteria to use when interpreting findings, basis for discussion on most subsequent publications; 36 are atypical melanocytic nevus of the genital type; describes three types of MVM and give guidelines for clinical management; with revision, many lesions were not confirmed to be MVM; 30% of AMNGT initially misdiagnosed as melanoma Cook, 2010 Special site nevi Mini symposium 0 NOSS description per anatomical site Elder, 2006 Nevi of special sites Narrative 0 No Describe melanoma versus dysplastic nevus versus atypical nevus of special site; educational Fu et al., 2021 Density of melanocytes in VLS Case control 30 cases, 15 controls, 7 early, and 8 late VLS Yes Density and thickness of epidermis in VLS, found fewer melanocytes in VLS Haupt and Stern, 1995 Pagetoid melanocytosis in different types of melanocytic lesions Case series 218 melanocytic lesions, 5 of the vulva (ages 22‒31) No Included because of histological information, discuss in which nevi is there Pagetoid melanocytosis: in vulva nevi, 80%, highest rate except for melanomas; describe Pagetoid melanocytosis: upward discontinuous extension of melanocytes into the superficial epidermis Mason et al., 2011 Overview and examples of NOSS Review 0 No Conclude no clear diagnostic criteria for NOSS, which gives pitfall for over diagnosis of melanoma; coin the abbreviation NOSS = nevus of special site; well-written, systemati...…”

“…A total of 13 publications on the histopathology and immunohistochemistry of melanomas and melanocytic lesions met the inclusion criteria ( Ahn et al., 2016 ; Blessing, 1999 ; Brenn, 2011 , 2018 ; Christensen et al., 1987 ; Clark et al., 1998 ; Cook, 2010 ; Elder, 2006 ; Fu et al., 2021 ; Haupt and Stern, 1995 ; Mason et al., 2011 ; Skelton et al., 1991 ; Wick, 2015 ). Clark et al.…”

“…Histopathology and Immunohistochemistry of melanoma, vulvar naevi. Thirteen publications on the histopathology and immunohistochemistry of melanomas and melanocytic lesions met the inclusion criteria (Ahn et al, 2016, Blessing, 1999, Brenn, 2011, 2018, Christensen et al, 1987, Clark W.H et al, 1998, Cook, 2010, Elder, 2006, Fu et al, 2021, Haupt and Stern, 1995, Mason et al, 2011, Skelton Iii et al, 1991, Wick, 2015. Clark (Clark W.H et al, 1998) introduced the term atypical melanocytic tumor of the genital type (AMNGT), subsequently abbreviated to atypical genital naevus (AGN).…”