{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:47:37Z","timestamp":1760147257390,"version":"build-2065373602"},"reference-count":13,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Medical Centre Ljubljana","award":["TP20220109"],"award-info":[{"award-number":["TP20220109"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: There is a broad spectrum of vulvar pigmented lesions that differ based on their histopathological and clinical features. Chronic vulvar purpura is a rare entity, associated with a broad morphological spectrum, from lichen aureus, Zoon\u2019s vulvitis, pigmented purpuric dermatosis and with lichen planus as in our case. Case presentation: In this article we discuss a case of an 86-year-old white woman with hyperpigmentation on her upper vulva, next to the introitus, with complaints of urine incontinence. Biopsy revealed subepithelial stromal lichenoid inflammatory infiltrate containing plasma cells, lymphocytes and some neutrophilic granulocytes as well as dilated and congested vessels. Hemosiderin deposits and erythrocyte extravasation were found. There was evidence of hyperkeratosis with hyper granulosis and erosions. Spongiosis was also noted. Few melanocytes were identified with no sign of malignancy. These findings correlate with the diagnosis of vulvar lichen planus. Conclusions: Chronic vulvar purpura is a clinical term used for different chronic inflammatory dermatoses presenting as red bluish or violaceous discolorations on the vulva, often associated with cayenne-pepper-like speckling. Considering a great overlap of possible diseases, the final diagnosis could be challenging. It is important to exclude a melanocytic tumour in these cases.<\/jats:p>","DOI":"10.3390\/medicina59020206","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T06:52:41Z","timestamp":1674197561000},"page":"206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vulvar Lichen Planus Presenting as Chronic Vulvar Purpura"],"prefix":"10.3390","volume":"59","author":[{"given":"Bo\u0161tjan","family":"Luzar","sequence":"first","affiliation":[{"name":"Institute of Pathology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0857-1433","authenticated-orcid":false,"given":"Anamarija","family":"Truden","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Turk","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vid","family":"Jan\u0161a","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Division of Gynaecology and Obstetrics, Department of Gynaecology, University Medical Centre, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Lewis","sequence":"additional","affiliation":[{"name":"St John\u2019s Institute of Dermatology, Guy\u2019s & St Thomas NHS Trust, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Calonje","sequence":"additional","affiliation":[{"name":"Department of Dermatopathology, St John\u2019s Institute of Dermatology, St Thomas\u2019s Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9698-2130","authenticated-orcid":false,"given":"\u0160pela","family":"Smrkolj","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Division of Gynaecology and Obstetrics, Department of Gynaecology, University Medical Centre, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1034\/j.1600-0560.2003.00107.x","article-title":"Chronic vulvar purpura: Persistent pigmented purpuric dermatitis (lichen aureus) of the vulva or plasma cell (Zoon\u2019s) vulvitis?","volume":"30","author":"Li","year":"2003","journal-title":"J. Cutan. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/00000372-200212000-00001","article-title":"Balanitis of Zoon: A clinicopathologic study of 45 cases","volume":"24","author":"Weyers","year":"2002","journal-title":"Am. J. Dermatopathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/S0190-9622(89)80278-6","article-title":"Lichen aureus of the glans penis as an expression of Zoon\u2019s balanitis","volume":"21","author":"Kossard","year":"1989","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1053\/j.semdp.2020.09.005","article-title":"Lichenoid dermatoses involving the vulva: A clinical-pathologic correlation(\u2730)","volume":"38","author":"Shalin","year":"2021","journal-title":"Semin. Diagn. Pathol."},{"key":"ref_5","first-page":"29","article-title":"Vulvitis de Zoon","volume":"25","author":"Jonquieres","year":"1975","journal-title":"Arch. Argent. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1111\/cup.12541","article-title":"Vulvar dermatoses: A histopathologic review and classification of 183 cases","volume":"42","author":"Chan","year":"2015","journal-title":"J. Cutan. Pathol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Spigariolo, C.B., Giacalone, S., and Nazzaro, G. (2021). Pigmented Purpuric Dermatoses: A Complete Narrative Review. J. Clin. Med., 10.","DOI":"10.3390\/jcm10112283"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/j.1365-2133.2010.10043.x","article-title":"Features of pigmented vulval lesions on dermoscopy","volume":"164","author":"Julien","year":"2011","journal-title":"Br. J. Dermatol."},{"key":"ref_9","first-page":"54","article-title":"Vulvovaginal gingival lichen planus: Report of two cases and review of literature","volume":"9","author":"Lucchese","year":"2016","journal-title":"Oral Implantol."},{"key":"ref_10","first-page":"97","article-title":"Psychiatric disorders in oral lichen planus: A preliminary case control study","volume":"32","author":"Lauritano","year":"2018","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Minervini, G., Basili, M., Franco, R., Bollero, P., Mancini, M., Gozzo, L., Romano, G.L., Marrapodi, M.M., Gorassini, F., and D\u2019Amico, C. (2022). Periodontal Disease and Pregnancy: Correlation with Underweight Birth. Eur. J. Dent.","DOI":"10.1055\/s-0042-1757906"},{"key":"ref_12","first-page":"101","article-title":"How social media meet patients\u2019 questions: YouTubeTM review for children oral thrush","volume":"32","author":"Romano","year":"2018","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1097\/OGX.0000000000000834","article-title":"Diagnosis and Management of Vulvovaginal Lichen Planus","volume":"75","author":"Jacques","year":"2020","journal-title":"Obstet. Gynecol. Surv."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/2\/206\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:11:43Z","timestamp":1760119903000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/2\/206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,20]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["medicina59020206"],"URL":"https:\/\/doi.org\/10.3390\/medicina59020206","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2023,1,20]]}}}