Zoon's vulvitis

Abstract

Introduction: Zoon's vulvitis is a rare, benign, chronic mucositis that affects the genital mucosa in the form of delimited erythematous plaques. The pathogenesis is unknown; predisposing factors such as infections, excessive sweating, poor hygiene, and trauma have been postulated that could trigger an immune response.
Objective: to present a case of Zoon's vulvitis and explore the key points of the diagnosis and management of this pathology.
Case report: a 37-year-old female who attended the consultation for leucorrhea and vulvar pruritus. On physical examination, a 2x1cm reddish lesion with an irregular contour was observed on the inner side of the left labia minora, not painful on palpation and not bleeding. Speculoscopy revealed leucorrhoea and cervicitis. Vaginal suppositories are indicated for 3 days and betamethasone for the lesion. A cytology was taken with a negative result for malignancy. The patient came to the consultation 1 month later, reporting notable improvement in vaginal discharge, but the lesion in the labia minora had increased in size and reported burning. A biopsy was taken, the results of which reported squamous epithelium and the presence of a chronic inflammatory infiltrate made up of mature plasma cells (approximately 70% of the infiltrate), lymphocytes, Russell bodies, and histiocytes with hemosiderin. Clobetasol cream is indicated for the management of vulvitis every 12 hours for 1 month. The patient evolved satisfactorily, without complications.
Conclusions: because the symptoms are non-specific, it is necessary to make a differential diagnosis with other vulvar dermatoses, such as systemic diseases, sexually transmitted infections, precancerous lesions, etc.