An oral component

Case notes

A 47-year-old patient was referred to our Vulvar Diseases Clinic for severe vulvovaginal burning, dyspareunia, and postcoital bleeding. These symptoms had been present for several months and coincided with gingival pain. Upon examination, the patient’s vulvar vestibule was brightly erythematous and eroded; diffuse atrophy of the labia minora and secondary vestibular stenosis were also evident ( Figure 1 ). Similar patterns of erythema and atrophy were present along the lower vaginal walls. The patient’s gingivae were diffusely red and atrophic as well ( Figure 2 ). Both the genital and gingival lesions had marked well-defined white borders that identified the separation between normal and altered surfaces. Histopathology of a vulvar punch-biopsy revealed acanthosis and a lymphocytic infiltrate around the basal layer ( Figure 3 ).