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Related Experiment Videos

Histopathologic features of vulvar vestibulitis

S Chadha1, W L Gianotten, A C Drogendijk

  • 1Department of Pathology, University Hospital Dijkzigt, Rotterdam, The Netherlands.

International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists
|February 25, 1998
PubMed
Summary

Vulvar vestibulitis, a type of vulvodynia, shows chronic inflammation in biopsies. The exact cause of this vulvar inflammation remains unclear, despite ruling out human papillomavirus (HPV).

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Area of Science:

  • Gynecologic pathology
  • Vulvar diseases
  • Immunohistochemistry

Background:

  • Vulvar vestibulitis, a subset of vulvodynia, affects 15% of patients in general gynecologic practices.
  • Limited research exists on the pathologic features of vulvar vestibulitis, with no prior studies including a control group.

Purpose of the Study:

  • To analyze histopathologic features of vulvar vestibulitis.
  • To investigate potential etiologic factors, including human papillomavirus (HPV), in vulvar vestibulitis.
  • To compare histopathologic findings between patients with vulvar vestibulitis and age-matched controls.

Main Methods:

  • Analysis of punch biopsies from the vulvar vestibule of 12 patients with vestibulitis and 12 age-matched controls.
  • Histopathologic examination for inflammatory infiltrates, glandular abnormalities, squamous metaplasia, and epithelial hyperplasia.

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  • Immunohistochemistry for immunoglobulins (IgG, IgA, IgM) and in situ hybridization for HPV types 6, 11, 16, and 18.

    • Main Results:

    • All vestibulitis patients exhibited a chronic inflammatory infiltrate (mild, moderate, or severe), predominantly T-lymphocytes, with normal T-helper suppressor ratios.
    • Minor vestibular glands, squamous metaplasia, and epithelial hyperplasia were observed in a significant percentage of patients.
    • HPV was not detected in any patient or control samples; IgG-positive plasma cells were present in 75% of patients, suggesting chronic irritation.

    Conclusions:

    • Histopathologic abnormalities in vulvar vestibulitis are characterized by a chronic inflammatory reaction of the vulvar vestibule mucosa.
    • The specific cause of this chronic inflammation in vulvar vestibulitis remains undetermined.
    • Autoimmune etiology cannot be excluded or confirmed based on current findings.