Plasma cell vulvitis: A systematic review

Samantha Sattler, Ashley N. Elsensohn, Melissa M. Mauskar, Christina N. Kraus

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

Background: Plasma cell vulvitis (PCV) is an inflammatory vulvar dermatosis that is not well characterized. Diagnosis is often delayed, and the condition can be refractory to treatment. To date, there are no systematic reviews on this topic. Objective: This study aimed to provide a systematic review of PCV, including epidemiologic, clinical, and histopathologic findings, as well as associated comorbidities and treatment options. Methods: A primary literature search was conducted using the PubMed, Ovid Medline, Cochrane, and CINAHL databases. Results: Fifty-three publications with 196 patients (mean age: 55.3 ± 14.5 years) were included. The majority of studies were case reports and case series. Common symptoms included burning/stinging (52%), dyspareunia (44%), and pruritus (41%). Common findings included erythema (84%), glistening/shiny appearance (29%), well-demarcated lesions (25%), and erosions (22%). Common anatomic sites were the labia minora (45%), introitus (31%), and periurethral (19%). Fifty-three percent of patients had a solitary lesion. Common histologic findings were a predominant plasma cell infiltrate (88%), presence of other inflammatory cells (55%), hemosiderin/siderophages (46%), and epidermal atrophy (43%). Topical corticosteroids (64%) and tacrolimus ointment (13%) were the most frequent treatment modalities. In most reports, previous treatments were tried, and there was a diagnostic delay. Conclusion: PCV is likely underrecognized and should be considered in patients with erythema of the mucous and modified mucous membranes, symptoms of burning or stinging, and a predominant plasma cell infiltrate on histopathology. First-line therapy should begin with high-potency topical corticosteroids, with the most evidence for clobetasol 0.05% or tacrolimus 0.1% ointment. Prospective studies are needed to further characterize this condition and to develop treatment guidelines.

Original languageEnglish (US)
Pages (from-to)756-762
Number of pages7
JournalInternational Journal of Women's Dermatology
Volume7
Issue number5
DOIs
StatePublished - Dec 2021

Keywords

  • Plasma cell mucositis
  • Plasma cell vulvitis
  • Vulvar disease
  • Zoon's vulvitis

ASJC Scopus subject areas

  • Dermatology

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