Table 1 Summary of VCD cases in clinical, histological, Imaging findings and management
From: Vulvar Crohn’s disease in an adolescent diagnosed after unsuccessful surgical treatment
Clinical presentation | Asymmetric/symmetric vulvar swelling Vulvar pain Aphthoid or linear “knife-like” vulvar ulcer (often extends to groin) Hypertrophic exophytic vulvar lesion/ Scarring, Plaque, Pedunculated tags of tissue Vulvar abscess with sinus tract Vesicles, Papules/nodules at vulva Vaginal discharge Vulvar itching Perianal skin tags/fissure |
Histological finding of vulvar lesion | Noncaseating granuloma Mixed inflammatory cell infiltrates Fibrosis Dilatation of lymphatics and capillary vessels Hyperkeratosis Dermal thickening Vascular ectasia |
Imaging study | |
Pelvis MRI | Rectovaginal/Perianal fistula Perineum abscess Perineum marked edema Perineum thickening Small volume lymphadenopathy with evidence of fissuring in the perianal region. |
Abdomen-Pelvis CT | Vulvar abscess and surrounding inflammation |
Perineal sonography | Diffuse hypoechogenicity Increased dermal thickness Diffusely elevated color doppler signal by local inflammation |
Management | Corticosteroid Immunosupressant |