{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:51:43Z","timestamp":1787014303347,"version":"build-2736575974"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T00:00:00Z","timestamp":1632096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to characterise a large cohort of non\u2010invasive, human papillomavirus (HPV) and p53\u2010independent verruciform lesions, such as \u2018vulvar acanthosis with altered differentiation\u2019 (VAAD), \u2018differentiated exophytic vulvar intra\u2010epithelial lesion\u2019 (DEVIL) and \u2018verruciform lichen simplex chronicus\u2019 (vLSC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      From January 2008 to December 2020 we retrospectively identified 36 eligible patients with verruciform non\u2010invasive lesions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936) and collected clinical, histological and follow\u2010up parameters. Verruciform non\u2010invasive lesions occurred at a median age of 71\u2009years, with a median follow\u2010up of 33.5\u2009months. Clinically, pruritus was only reported in patients with VAAD (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093, 21%). Lesion colour was significantly different across categories (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.028). Apart from the histopathological criteria already known to distinguish these entities (hypogranulosis, epithelial pallor and low\u2010magnification architecture), no other significant criteria were discovered and significant overlap was observed, particularly between VAAD and DEVIL. Patients with vLSC trended towards longer survival without recurrence compared to VAAD and DEVIL (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.082), but showed comparable invasion\u2010free survival interval (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.782). Squamous cell carcinomas (SCC) associated with either VAAD, DEVIL or vLSC displayed similar clinical, histopathological and biological parameters. In non\u2010invasive precursor lesions, stromal oedema was associated with invasion (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.015) and remained so upon Cox regression analysis (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study of HPV and p53 independent non\u2010invasive verruciform lesions of the vulva highlights significant clinical, histopathological and biological overlap between VAAD, DEVIL and vLSC, suggesting that these pre\u2010invasive lesions should be viewed as a spectrum. We also show that stromal features such as oedema might play an import role in progression to invasion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/his.14451","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T15:48:16Z","timestamp":1626364096000},"page":"975-988","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["DEVIL, VAAD and vLSC constitute a spectrum of HPV\u2010independent, p53\u2010independent intra\u2010epithelial neoplasia of the vulva"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5444-0349","authenticated-orcid":false,"given":"Simon F","family":"Roy","sequence":"first","affiliation":[{"name":"D\u00e9partement de Pathologie Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al University of Montr\u00e9al Montr\u00e9al Canada"},{"name":"D\u00e9partement de Pathologie et de Biologie Cellulaire Universit\u00e9 de Montr\u00e9al Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahg","family":"Wong","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Pathologie Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al University of Montr\u00e9al Montr\u00e9al Canada"},{"name":"D\u00e9partement de Pathologie et de Biologie Cellulaire Universit\u00e9 de Montr\u00e9al Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8020-1544","authenticated-orcid":false,"given":"C\u00e9cile","family":"Le Page","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Pathologie Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al University of Montr\u00e9al Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danh","family":"Tran\u2010Thanh","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Pathologie Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al University of Montr\u00e9al Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maroie","family":"Barkati","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Radio\u2010oncologie Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Pina","sequence":"additional","affiliation":[{"name":"D\u00e9partement d\u2019Obst\u00e9trique et Gyn\u00e9cologie Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3267-2843","authenticated-orcid":false,"given":"Vincent Quoc\u2010Huy","family":"Trinh","sequence":"additional","affiliation":[{"name":"Department of Surgery Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurosh","family":"Rahimi","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Pathologie Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al University of Montr\u00e9al Montr\u00e9al Canada"},{"name":"D\u00e9partement de Pathologie et de Biologie Cellulaire Universit\u00e9 de Montr\u00e9al Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13989"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-17-1302"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200405000-00012"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2016.187"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2019.01.001"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-020-0524-1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000572"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-020-00651-3"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-020-0573-5"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000422"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2016.05.020"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000486"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12014-017-9175-8"}],"container-title":["Histopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.14451","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/his.14451","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.14451","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T16:47:53Z","timestamp":1692809273000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/his.14451"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,20]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/his.14451"],"URL":"https:\/\/doi.org\/10.1111\/his.14451","archive":["Portico"],"relation":{},"ISSN":["0309-0167","1365-2559"],"issn-type":[{"value":"0309-0167","type":"print"},{"value":"1365-2559","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,20]]},"assertion":[{"value":"2021-06-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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