[Cytologic and histologic studies of hormone dependence of the skin of the external female genitalia].

The value of vaginal cytology for functional hormonal diagnosis is generally recognized. Largely unknown was that the cornified cells obtained from the skin of the vulva likewise show morphologically demonstrable signs of hormonal effects. The cytological analysis of 429 cytological smears of the vulva obtained from 174 women during 88 cycles and the histological analysis of excisions of the vulva obtained at 65 female autopsies showed that the parakeratotic type of cornification is significantly more frequent in the premenopause than in the postmenopause. During the menstrual cycle a parakeratosis index can be identified which is parallel to the well known eosinophilic and karyopyknotic indices of cytological smears from the vagina and corresponds as well to the cyclic levels of estradiol in the serum. Exogenous administration of estrogen during the menopause results in a drastic increase of the parakeratotic index which is normally low following the menopause. These observations show that not only the uncornified squamous epithelium of the vagina but also the cornified squamous epithelium of the vulva reacts to endogenous and exogenous hormonal stimulation although in a different pattern.