A 22-year-old woman consulted in our dermatology department with a 2-year history of severe vulvodynia and vulvar lesions. On examination, a symmetrical, well-circumscribed plaque occupied the periurethral area and introitus, extending to the labia minora. It had a bright red color and displayed peripheral “cayenne pepperlike” dots ( Figure 1 ). No other mucosal or skin lesion was observed. Furthermore, the patient reported a history of intense vulvodynia concerning its development, which prevented any form of sexual contact and made vulvar examination difficult. A biopsy was performed, showing a lichenoid infiltrate with an abundance of plasma cells occupying the superficial dermis in addition to hematic extravasation, hemosiderin deposits, and polygonal keratinocytes ( Figure 2 ). A diagnosis of Zoon’s vulvitis was made. Plasma cell vulvitis (or Zoon’s vulvitis) is a rare dermatosis affecting women of various ages. Characteristic, bright red plaques may appear on mucosal surfaces of the vulva. Pruritus, dyspareunia, and pain often lead to a decrease in sexual and overall quality of life for these patients. Medium- to high-potency topical corticosteroids are usually used as first-line treatment.
