[Papillomavirus infection of the vulva]

The role of Papillomavirus (PV) in the development of external genital neoplasias has recently been documented. Fifty cases of condyloma acuminata, dystrophy, Bowenoid papulosis, carcinoma in situ and invasive carcinoma of the vulva were examined for the presence of PV structural antigens with an immunoperoxidase method on formalin-fixed, paraffin-embedded tissue. Using the avidin-biotin-peroxidase complex (ABC) technique on vulvar tissue obtained from biopsy and vulvectomy specimens, PV structural antigens were identified in association with condyloma acuminata in 5 of 6 cases (83.3%), with hyperplastic dystrophy in 1 of 11 cases (9.1%), with atypia in 9 of 14 cases (64.3%), with Bowenoid papulosis in 2 of 2 cases (100%), with carcinoma in situ in 4 of 7 cases (57.1%) and with invasive carcinoma in three of 3 cases (100%), but in none of the examples of 7 lichen sclerosus cases. A PV-inducing morphologic change in koilocytosis was present in 30 instances of all the vulvar lesions. The results of this study, therefore, provide immunohistochemical evidence demonstrating the close relationship of papillomavirus to vulvar disease ranging from condyloma acuminata and moderate atypia to carcinoma in situ and invasive carcinoma.