British Journal of Dermatology

A microRNA signature to predict risk progression of vulvar lichen sclerosus to squamous cell carcinoma

High-grade cervical squamous intraepithelial lesions in female partners of men with high-grade penile squamous intraepithelial lesions: a monocentric retrospective study

We have conducted the first study to focus on the presence of cervical human papillomavirus (HPV) lesions in the female partners of males with high-grade penile squamous intraepithelial lesions (PHSILs). A histologically confirmed cervical squamous intraepithelial lesion (SIL) in female partners was observed in 81% of cases, with high-grade SIL seen in more than two-thirds of cases and low-grade SIL in a third. It is important to screen females whose male partners have PHSIL, in order to detect a clinical HPV lesion early and treat it, if necessary. Our results indicate that a HPV test and reflex cytology (if the HPV test is positive) are necessary for the female partners of males with PHSIL. If there is an abnormal Pap smear, colposcopy should be performed.

Adverse healthcare experiences are correlated with increased time to diagnosis in women with vulvar inflammatory dermatoses: a retrospective cohort survey

This retrospective cohort survey of over 300 women examined diagnostic delay in vulvar dermatoses compared with nonvulvar control conditions (e.g. psoriasis or atopic dermatitis). Adverse healthcare experiences (e.g. uncertainty of which provider to consult, embarrassment in talking to providers) occurred more often for participants with vulvar disease and were significantly correlated with increased time to diagnosis in this group, which was not the case in control conditions. The findings suggest opportunities to improve care for people with vulvar disease.

Bowen disease of the nail apparatus with HPV 16 positivity and resolution with human papillomavirus vaccination

Three cases of recalcitrant cutaneous warts treated with quadrivalent human papillomavirus (HPV) vaccine: the HPV type may not determine the outcome

DNA methylation testing for vulvar cancer risk stratification in patients with high-grade vulvar intraepithelial neoplasia: a population-based cohort study

Abstract Background High-grade vulvar intraepithelial neoplasia (VIN) is the precursor of vulvar cancer. The main variants are human papillomavirus (HPV)-associated high-grade squamous intraepithelial lesion (HSIL) and HPV-independent VIN, often clinically referred to as differentiated VIN (dVIN) and associated with vulvar dermatoses, usually lichen sclerosus. Surgical treatment of high-grade VIN often leads to genital deformity, impaired sexual function and reduced quality of life. To optimize clinical management, accurate biomarkers providing information on the cancer risk of high-grade VIN are needed. Objectives To investigate the prognostic value of a three-gene methylation marker panel and other potential risk factors for the risk of progression to cancer in patients with HSIL and dVIN. Methods From a population-based cohort of patients diagnosed with high-grade VIN, patients with a histopathologically confirmed diagnosis of HSIL (n = 578) and dVIN (n = 46) were selected. All lesions were tested by a three-gene methylation panel including the genes ZNF582, SST and miR124-2. The vulvar cancer risk and the prognostic value of methylation status, age, HPV genotype, wild-type vs. mutant p53 immunohistochemistry status and presence of lichen sclerosus were estimated by Kaplan–Meier and Cox regression, respectively. Results Vulvar cancer developed in 26 of 578 patients with HSIL (4.5%) and in 21 of 46 with dVIN (46%) within 5 years. In HSIL, positive methylation status was identified as the only prognostic factor for vulvar cancer development [hazard ratio (HR) 4.87, 95% confidence interval (CI) 1.20–21.45]. The prognostic value of methylation remained present when selecting patients who did not receive radical surgical excision as their primary treatment. In this group, the 5-year cancer risk was 7.7% in methylation-positive HSIL and 1.4% in methylation-negative HSIL (P = 0.008). In dVIN, mutant p53 status was the sole prognostic risk factor for progression to cancer (HR 7.67, 95% CI 1.78–33.08). Conclusions Despite wide CIs, the three-gene methylation test serves as a promising prognostic tool for cancer risk stratification in patients with vulvar HSIL. Patients with methylation-negative HSIL carry a low cancer risk, allowing for more conservative management strategies. This approach may help avoid overtreatment, reducing morbidity and improving quality of life.