Department of Dermatology, Broadgreen Hospital, Liverpool, UK.
J Low Genit Tract Dis. 2011 Apr;15(2):158-60. doi: 10.1097/LGT.0b013e3181eb30ff.
Vulval ulceration can be caused by a wide variety of etiological factors including bacterial and viral infections, granulomatous disorders, and malignancy. Superficial granulomatous pyoderma (SGP) is a variant of pyoderma gangrenosum. It is characterized by localized ulcerative lesions that may be precipitated by surgery. We report a case of vulval SPG in an immunocompromised patient.
A 51-year-old woman presented with a 6-week history of severe vulval pain, bleeding, and rapidly progressing ulceration. She had a previous history of relapsed follicular non-Hodgkin lymphoma and was currently receiving regular MabThera (Welwyn Garden City, Hertfordshire, UK). Examination revealed deep ulceration involving the entire vulva and extending into the vagina with areas of necrosis. Histological examination showed ulceration with sparse granulomas and eosinophils. The clinical and histological findings confirmed a diagnosis of SGP.
Vulval ulceration in an immunocompromised patient has a broad differential diagnosis. The possibility of a granulomatous condition such as SGP must always be considered.
外阴溃疡可由多种病因引起，包括细菌和病毒感染、肉芽肿性疾病和恶性肿瘤。浅表性化脓性坏疽性脓皮病（SGP）是坏疽性脓皮病的一种变异型。其特征为局灶性溃疡性病变，可能由手术引发。我们报告一例免疫功能低下患者的外阴 SGP。
一名 51 岁女性因严重外阴疼痛、出血和迅速进展的溃疡就诊，病史 6 周。她曾患有复发性滤泡性非霍奇金淋巴瘤，目前正在接受常规 MabThera（英国赫特福德郡韦林花园城）治疗。检查发现整个外阴和阴道内有深溃疡，伴有坏死区域。组织学检查显示溃疡伴稀疏的肉芽肿和嗜酸性粒细胞。临床和组织学检查确诊为 SGP。
免疫功能低下患者的外阴溃疡有广泛的鉴别诊断。始终应考虑到 SGP 等肉芽肿性疾病的可能性。
