This is a special type of VIN. The lesion grows horizontally within the epidermis. The rete ridges tend to push into the dermis without actually penetrating it.
The characteristic histologic picture is presence of Paget cells in the epidermis. The cells are large— round or oval in shape with abundant pale cytoplasm.
There may be presence of mucopolysaccharides in most of the cells. Nuclear mitotic figures are rare.
Associated adenocarcinoma of apocrine gland (adenocarcinoma in situ) is present in about 10 percent of the cases. There is high incidence (30%) of associated carcinomas of other organs (breast, cervix, ovary, GI tract and bladder).
are mainly pruritus, vulvar soreness, pain or bleeding.
Local examination reveals—labia majora appear red, scaling, with elevated lesion. There may be associated white lesions. The skin is usually indurated.
Some medicines which may prove beneficial are:-