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Vulvar dermatoses-Can a pattern-based approach improve diagnostic yield?

Lavleen Singh1, Kalpana Kumari1, Sonal Sharma1

  • 1University College of Medical Sciences, New Delhi, India.

Journal of Cutaneous Pathology
|November 24, 2022
PubMed
Summary
This summary is machine-generated.

The 2006 International Society for the Study of Vulvovaginal Disease (ISSVD) classification improves vulvar dermatoses (VD) reporting. Dermatopathologist review enhances diagnostic accuracy for these challenging biopsies.

Keywords:
ISSVD 2006differentiated vulvar intraepithelialneoplasiavulvar dermatoses

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Area of Science:

  • Dermatopathology
  • Gynecologic Pathology
  • Histopathology

Background:

  • Vulvar dermatoses (VD) present diagnostic challenges due to vulvar heterogeneity and limited specialist experience.
  • The International Society for the Study of Vulvovaginal Disease (ISSVD) developed a classification system for VD based on histopathological tissue reactions.
  • This study evaluates the utility of the 2006 ISSVD classification and the impact of expert review on diagnostic yield.

Purpose of the Study:

  • To assess the effectiveness of the 2006 ISSVD classification in reporting vulvar dermatoses.
  • To determine if review by dermatopathologists improves the diagnostic accuracy of vulvar biopsies.

Main Methods:

  • Retrieved 106 vulvar biopsy reports, focusing on 55 benign non-infectious conditions.
  • Initial diagnoses were compared against review diagnoses assigned by three dermatopathologists using the ISSVD 2006 classification.
  • Analyzed the impact of dermatopathologist review on diagnostic yield.

Main Results:

  • Sclerotic (34.6%), spongiotic (18%), and acanthotic (14.5%) patterns were the most common tissue reactions.
  • The rate of non-specific or descriptive reports significantly decreased from 83.6% to 1.8% after implementing the ISSVD 2006 classification and dermatopathologist review.

Conclusions:

  • Utilizing tissue reaction patterns in vulvar biopsy reporting enhances lesion comprehension and clinical relevance.
  • Dermatopathologist review of challenging vulvar biopsies demonstrably increases diagnostic yield and accuracy.