Vulvar Elastosis: A Novel Diagnostic Entity

Sharlene Helene C. See, Timothy L. Tan, Traci A. Kurtzer, Pedram Gerami, Joan Guitart, Pedram Yazdan

Research output: Contribution to journalArticlepeer-review

Abstract

ABSTRACT: In vulvar biopsies, we have observed histopathologic abnormalities of elastic fibers identical to solar elastosis, with thick, curled, and irregular pale grey fibers in the dermis. In severe cases, changes resemble nodular solar elastosis. We retrospectively evaluated 238 vulvar biopsies with the goal of defining and characterizing changes of vulvar elastosis. Of 238 vulvar biopsies reviewed, 107 (45%) exhibited vulvar elastosis. Patients with vulvar elastosis were older (mean = 65 years old) compared to those without (mean = 44 years old). Sixty-six (62%) were graded as mild, 27 (25%) moderate, and 14 (13%) severe. Vulvar elastosis was significantly more common in women ≥45 years old (P-value < 0.001). There was moderate correlation between age and severity (correlation coefficient = 0.55, P-value < 0.001). Vulvar elastosis was observed in a variety of inflammatory and non-inflammatory pathologies. In 5 cases, the sole pathology was vulvar elastosis presenting clinically as either a pruritic or painful white to white-yellow papule or plaque, or vulvar pain or burning without a clinical lesion. Vulvar elastosis is a novel diagnostic entity occurring in a sun-protected site and its pathogenesis may be a degenerative phenomenon possibly related to advancing age and/or hormonal changes.

Original languageEnglish (US)
Pages (from-to)418-422
Number of pages5
JournalThe American Journal of dermatopathology
Volume43
Issue number6
DOIs
StatePublished - Jun 1 2021

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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