Vulvar and Oral Lesions in a 34-Year Old Woman

Beverly J. Brent, MT(ASCP)BB; Meenakshi Nandedkar, CDR, MC, USNR


Lab Med. 2005;36(10):644-646. 

In This Article


34-year-old woman.

Intermittent fever and vulvar pain.

The patient reported that she frequently had re-occurring oral and vulvar lesions.

Large, erosive, bilateral, necrotic vulvar and oral lesions were found, which were painful on touching. Some necrotic debris at the urethra was noted.

( Table 1 ), (Figure 1A and 1B).

Patient's peripheral blood smear (A) illustrating leucopenia with blasts and neutrophils with bilobed nuclei (Pelger-Huet anomaly) and bone marrow aspirate (B) illustrating a hypercellular bone marrow with an increased number of immature/undifferentiated cells and a decreased number of erythroid cells. Wright-Giemsa stain; 100x magnification.

A vulvar biopsy revealed marked acute inflammation associated with necrosis and obliterative vasculitis but no epithelioid granulomas were identified. A bone marrow biopsy was performed with results as shown in ( Table 2 ) and (Figure 1B).


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