Tinea of the vulva: a histopathological case analysis

Abstract

Introduction: tinea of the vulva is a difficult clinical entity which may well go unnoticed in a biopsy.

Objective: presenting the case of a woman suffering this disease, diagnosed by biopsy, and making some comments emphasising the value of histopathological diagnosis.

Methodology: a vulvar biopsy was taken as the patient had complained of persistent pruritis. No clinical history was obtained. The biopsy revealed lichenified psoriasiform dermatitis, parakeratosis and groups of neutrophils in the horny layer and infundibulum; deep dermal papillae, lymphocytes and vertical fibrosis were visible in the dermis. Although such findings are also seen in psoriasis, PAS staining was done due to the presence of neutrophils, showing abundant infundibular hyphae, thereby confirming the diagnosis of tinea of the vulva.

Conclusions: this rare entity has a lichenified psoriasiform histological pattern. The finding of neutrophils in the horny layer must always lead to suspecting the presence of tinea. PAS staining is an easy way to confirm such diagnosis. Reviewing the literature revealed that tinea of the vulva is an extension of tinea cruris, most frequently caused by Trichophyton rubrum. Differential diagnosis includes candidiasis, psoriasis, and contact dermatitis.