THE UNDER-REPORTING OF SKIN-DISEASE IN ASSOCIATION WITH SQUAMOUS-CELLCARCINOMA OF THE VULVA

Histology sections from 61 cases of squamous cell carcinoma (SCC) of t he vulva presenting after 1988 were reviewed for evidence of associate d epithelial abnormality. Of the 50 patients with epithelium adjacent to the tumour, 24 had histological evidence of lichen sclerosus (LS), 20 of severe vulvar intraepithelial neoplasia (VIN 3), 22 of human pap illoma virus (HPV) infection and three of lichen planus (LP). The clin ical records and the original histology report were also subsequently reviewed and with the exception of VIN 3, these disorders were poorly reported by both clinicians and pathologists. Lichen sclerosus was dia gnosed clinically in only two of the 36 hospital records available for inspection. Old terminology was used to describe some patients with e pithelial disease (erythroleucoplakia in one patient with LS, leucopla kia in two patients with LS and one with LP). This study demonstrates the need to adopt standard nomenclature and increase the awareness of epithelial disease associated with SCC of the vulva among clinicians a nd pathologists.