vulvar nevus
Introduction
Introduction to vulvar pigmentation The vulvar pigmentation is divided into black sputum and blue sputum. The importance of vulvar sputum is that it has the potential to develop malignant melanoma, and its mortality is high. 40% of malignant melanomas originate from black sputum, and pigmented sputum Light brown, dark brown to black, diameter 1mm ~ 2cm, some in the skin, some bulge on the skin, there are also nipples or sputum like the skin, there may be hair or no hair. Blue mites occur mostly on the face and forearms, and are most common on the back of the hand, and the outer cathode is rare. basic knowledge Sickness ratio: 5% Susceptible people: women Mode of infection: non-infectious Complications: vaginitis vulvitis
Cause
Vulvar pigmentation cause
(1) Causes of the disease
The vulvar pigmentation is caused by excessive growth of pigment cells. The sputum cells are derived from two kinds of cells, namely the pigment cells in the epidermis and the Schwann cells of the cutaneous nerve. The border ridge is mainly derived from pigment cells, and the sputum is derived from the epithelium. Pigment cells and dermal nerve sheath cells, which grow in various parts of the body, may be malignant due to the presence of sputum in the vulva.
(two) pathogenesis
Pathologically, pigmented sputum is divided into 3 types, namely, border sputum, intradermal sputum, mixed sputum, and intradermal sputum is completely located in the skin. It is less common. Junction refers to the junction of sputum cells at the junction of epidermis and dermis, early sputum or Most of the baboons in childhood are junctions. When part or most of the border sputum enters the dermis, it is called mixed sputum. The mixed sputum cells are round or cubic, the membrane is clear, the cytoplasm is uniform, and contains melanin. The nuclear is large and the staining is light.
Pigments are very sensitive to the reaction of steroids (steroids). Piglets are often inconspicuous at an early age. After puberty, pigmented nevus gradually deepens and the volume increases. It is also suggested that pregnant women should be treated with preventive pigmented nevus. Allen et al. believe that pregnancy has nothing to do with pigmentation and malignant transformation, and there is still no clear evidence in this regard.
Pathological features of black carp
The naked eye is black, the surface is flat or bulging, even papillary, the surface can also have hair, the flat sputum is often the junction , the cells are black under the microscope, the cells are oval, semi-circular, clear cell membrane The cytoplasm is dark brown particles, the nucleus is unclear, and the sputum cells located deep in the dermis are often fusiform, and there is no pigment in the cytoplasm, indicating that the sputum cells are aging.
Blackbird is divided into 5 types:
(1) Pingyi: Mostly border type.
(2) Higher than the skin surface : mostly compound .
(3) papilloma: most of them are intradermal or complex.
(4) Dome : often in the skin type.
(5) There is a sputum: it is an intradermal type.
Pathological features of blue dragonfly
(1) Macroscopic view: a small blue nodule with a slightly raised boundary of 0.2 to 0.5 cm in diameter and a maximum of 1.5 cm. (2) Microscopically: located in the dermis, the sputum cells are fusiform pigment cells, which have cell protrusions, and the cells are bundled into a bundle, which is parallel to the epidermis surface. The cells sometimes extend into the subcutaneous fat tissue, and the cells are often called rich cell blue. mole.
Prevention
Vulvar pigmentation prevention
According to Holland (1949), although the skin of the vulva only accounts for 1% of the whole body epidermis, 7% to 10% of malignant melanoma in women occurs in the vulva, and the mortality rate is higher. Since vulvar black sputum may develop into malignant melanoma, it is essential to prevent its occurrence and cancer. To prevent the occurrence of vulvar pigmented tumors, the following points should be done:
1, regular physical examination: to achieve early detection, early diagnosis, early treatment.
2, good follow-up: to prevent the disease from getting worse.
3, pay attention to personal hygiene, especially the health of the genitals during menstruation and puerperium.
4, enhance physical fitness, improve their own immunity: pay attention to work and rest, more to participate in physical exercise, eat more fresh fruits and vegetables rich in vitamins.
Complication
Vulvar pigmented nevus complications Complications vaginitis vulvitis
Stimulation or friction can spread local inflammation and cause vulva and vaginitis.
Vaginitis is inflammation of the vaginal mucosa and submucosal connective tissue, and is a common disease in gynecological clinics.
In normal healthy women, due to anatomical and biochemical characteristics, the vagina has a natural defense function against pathogen invasion.
When the natural defense function of the vagina is destroyed, such as vulvar fibroid infection, the pathogen is easy to invade, leading to vaginal inflammation, and the vaginal epithelium is thin due to estrogen deficiency in young girls and postmenopausal women.
The intracellular glycogen content is reduced, and the vaginal pH is as high as about 7, so the vaginal resistance is low, which is more susceptible to infection than puberty and women of childbearing age.
Symptom
Symptoms of vulvar pigmentation Common symptoms Itching black sputum cell nodules
Gynecological examination revealed that the color of the enamel from light brown to black, can be flat or bulging, generally small.
Black cockroach
The predilection site is the size of the labia, mostly black, the surface is flat and the bulge is papillary. There are no special symptoms in the clinic. For example, after long-term stimulation or friction, local pain, itching, hemorrhage or inflammatory reaction may occur, and the labia majora may be seen during gynecological examination. See brown, light brown or blue-black plaque, slightly raised or flattened locally, some long hair, lesions are generally small, common to single hair, pigmented nevus sensitive to sex hormones, often increased in puberty, black, if pigmentation color Suddenly deepened, the part becomes shallow or radial changes, the area increases, the surrounding area is red, ulcer bleeding occurs, the patient has itching, etc. It is possible to turn the alarm into a malignant melanoma. The malignant melanoma from the sputum cells is younger. The tumor grows fast, the degree of malignancy is high, and early metastasis is easy to occur. Therefore, the correct diagnosis of vulvar melanin has special significance for the early prevention and treatment of melanoma, especially for young women. The identification of the two should be paid more attention.
2. Blue Dragonfly
It is 0.2-0.5cm, slightly raised, and the blue-black nodules with clear boundaries are asymptomatic.
Examine
Examination of vulvar pigmentation
The following checks can be done to rule out other diseases:
First, routine examination of vaginal secretions:
Vaginal secretions are liquids secreted by the female reproductive system, also known as leucorrhea. Observing the color and traits of vaginal secretions can clarify the lesions of the vulva or vagina.
Second, tumor marker examination: Tumor Marker (Tumor Marker) is a chemical substance that reflects the presence of tumors.
(1) Classification
1. Tumor tissue production, including: differentiation antigen; embryonic antigen (AFP, CEA); isoenzyme (NSE); hormone (HCG); tissue-specific antigen (PSA, freePSA): mucin, glycoprotein, glycolipid ( CA125); oncogenes and their products; polyamines.
2, tumor and host interaction, including: serum ferritin; immune complex; acute phase protein; isoenzyme; interleukin receptor; tumor necrosis factor.
Third, histopathological examination:
(1) Black cockroach:
1. Macroscopic view: The cockroach is black, the surface is flat or bulging, even nipple-like, the surface can also have hair, and the flat sputum is often the junction .
2, under the microscope: the cells are black, the cells are oval, semi-circular, the cell membrane is clear, the cytoplasm is dark brown particles, the nucleus is unclear, and the sputum cells located deep in the dermis are often fusiform, intracytoplasmic. No pigmentation, indicating aging of sputum cells.
(2) Blue Dragonfly:
1. Macroscopic view: a small blue nodule with a slightly raised boundary of 0.2 to 0.5 cm in diameter, no more than 1.5 cm.
2, under the microscope: located in the dermis, the sputum cells are spindle-shaped pigment cells, with cell protrusions protruding, the cells are bundled into bundles, parallel to the epidermis surface, the cells sometimes extend into the subcutaneous fat tissue, and the cells are often called rich cell blue sputum. .
Diagnosis
Diagnosis and differentiation of vulvar pigmented nevus
diagnosis
Diagnosis can be confirmed by clinical features and pathological biopsy.
Differential diagnosis
Pigmented milk
Head sputum (senile sputum) has a granular or thorny surface, which is easy to distinguish between the two.
2. Some atypical vulvar pigmented nevus
It has a slight nuclear susceptibility. It is distinguished from malignant melanoma. The former is a mature sputum cell and has no mitosis. The latter cells have some atypical genital pigmented dysplasia with mild nuclear heterogeneity. The difference is that the former has mature sputum cells and there is no mitosis in the cells.
