Читать книгу Ridley's The Vulva - Группа авторов - Страница 4
List of Illustrations
Оглавление1 Chapter 1Figure 1.1 The conceptus is enclosed within an acellular envelope, the zona ...Figure 1.2 The conceptus continues to differentiate forming (a) the chorion,...Figure 1.3 (a) The floor of the amniotic cavity, the dorsal surface of the b...Figure 1.4 Migration of primordial germ cells into the genital ridge from th...Figure 1.5 (a) As the neural tube is enclosed within the intraembryonic meso...Figure 1.6 (a) Midline section of the embryo after formation of the head and...Figure 1.7 (a) The primitive hindgut is enclosed within the embryonic tail f...Figure 1.8 (a) The paired primordia of the genital tubercle lie immediately ...Figure 1.9 The indifferent human embryo possesses mesonephric and paramesone...Figure 1.10 (a) The mesonephric duct, within the urorectal septum, opens int...Figure 1.11 (a) The fused paramesonephric ducts form the genital canal, the ...Figure 1.12 (a) The genital and anal membranes rupture. (b) In the female fo...
2 Chapter 2Figure 2.1 Anatomy of the normal vulva.Figure 2.2 Variation in appearance of normal labia minora. (a) Symmetrical l...Figure 2.3 Fordyce spots: yellow papules on inner labium majus.Figure 2.4 Anatomy of the clitoris.Figure 2.5 Hart’s line, which demarcates the junction of the keratinised ski...Figure 2.6 Openings of Bartholin’s ducts.Figure 2.7 Vestibular papillae. Multiple filiform projections of the vestibu...Figure 2.8 Histology of vestibular papillomatosis. Low power showing papilla...Figure 2.9 Hymenal remnants and tags.Figure 2.10 Urethral caruncle in a patient with lichen sclerosus.Figure 2.11 Midline section through pelvis and perineum.Figure 2.12 The urogenital diaphragm.Figure 2.13 The superficial structures of the perineum.Figure 2.14 A coronal section through the anal canal and ischiorectal fossa....Figure 2.15 The muscles of the pelvic walls and pelvic floor.Figure 2.16 Histology of normal labium majus.Figure 2.17 Lobulated anogenital mammary‐like gland with compact columnar ep...
3 Chapter 3Figure 3.1 Central loss of hair on mons pubis post menopause.
4 Chapter 5Figure 5.1 The multidisciplinary specialities that are required for patients...Figure 5.2 Diagnostic clues to be found at other sites.
5 Chapter 6Figure 6.1 Causes of vulval ulceration.Figure 6.2 Causes of vulval oedema.Figure 6.3 Diagrammatic section of normal skin.Figure 6.4 Features of cutaneous lesions.
6 Chapter 7Figure 7.1 Best site for biopsy in lichen planus.Figure 7.2 Example of poor biopsy technique resulting in a crushed specimen,...Figure 7.3 Allergens for testing placed in plastic trays.Figure 7.4 Allergens applied to the patient’s back.Figure 7.5 Positive reaction showing eczematous reaction at the site of appl...
7 Chapter 8Figure 8.1 (a) Ointments are thicker and greasy to apply, but better to use ...Figure 8.2 Fingertip unit.Figure 8.3 Steroid telangiectasia and atrophy in a patient using excessive q...
8 Chapter 9Figure 9.1 Clue cell.
9 Chapter 10Figure 10.1 C. albicans spores and hyphae.Figure 10.2 Acute candidiasis with inflammation.
10 Chapter 11Figure 11.1 Primary chancre on right inner labium majus.Figure 11.2 Vulval condylomata lata.
11 Chapter 12Figure 12.1 Bartholin’s abscess.
12 Chapter 13Figure 13.1 Lymphogranuloma venereum: aspiration of bubo.Figure 13.2 Lymphogranuloma venereum showing sinuses.
13 Chapter 14Figure 14.1 Flagellate trichomonas. Published in Wisdom, A and Hawkins, D. D...Figure 14.2 Discharge associated with trichomonas infection.
14 Chapter 15Figure 15.1 Genital herpes – grouped vesicles right labium majus.Figure 15.2 Perianal hypertrophic atypical herpes simplex in an immunosuppre...
15 Chapter 16Figure 16.1 Vulval and perianal papular warts.Figure 16.2 Condyloma acuminata.Figure 16.3 Extensive condylomata acuminata in an immunosuppressed patient....Figure 16.4 Histology of condyloma acuminata.
16 Chapter 17Figure 17.1 Umbilicated lesions of molluscum contagiosum.Figure 17.2 Scabetic nodules on the labia majora.
17 Chapter 18Figure 18.1 Amoebiasis – large exophytic vulval ulcer with sloughy base.
18 Chapter 19Figure 19.1 Tinea cruris, serpiginous spreading edge with central clearing....Figure 19.2 Tinea incognito.Figure 19.3a Bright field microscopy showing fungal hyphae in tinea.Figure 19.3b Fluorescence of fungal hyphae in tinea cruris using calcofluor ...Figure 19.4 Fluorescence of M. furfur in pityriasis versicolor using calcofl...Figure 19.5 Folliculitis showing small pustules centred on hair follicles.Figure 19.6 Cellulitis of left labium majus.Figure 19.7 Erythrasma in right inguinal fold. Well‐demarcated brownish disc...Figure 19.8 Vulval herpes zoster: third sacral nerve root is involved.Figure 19.9 Parvovirus 19 infection (a) Bathing trunk eruption. (b) Flexural...Figure 19.10 Acute genital ulcer affecting left labium majus.
19 Chapter 20Figure 20.1 Hypertrophic herpes simplex associated with IRIS.
20 Chapter 21Figure 21.1 Histological features of psoriasis. Hyperkeratosis and parakerat...Figure 21.2 Psoriasis: well‐defined erythema with scaling visible on the ker...Figure 21.3 Psoriasis: plaques on labia majora and perianal skin.Figure 21.4 Psoriasis of the perianal skin and natal cleft.
21 Chapter 22Figure 22.1 (a) Seborrhoeic eczema with erythema affecting labia majora and ...Figure 22.2 Histological features of lichen simplex.Figure 22.3 Perianal lichenification.Figure 22.4 Lichen simplex with lichenification of the labia majora.Figure 22.5 Lichen simplex with thickening on inner labia majora with some p...Figure 22.6 Eczema – fissuring over perineum.Figure 22.7 Lichen simplex showing thickening and increased pigmentation of ...Figure 22.8 Extensive and severe Jacquet’s dermatitis in an elderly patient ...Figure 22.9 Acute allergic contact dermatitis.
22 Chapter 23Figure 23.1 Lichen sclerosus: typical histological features. Thinning of epi...Figure 23.2 Lichen sclerosus, hypertrophic type with hyperkeratosis and elon...Figure 23.3 Early lichen sclerosus with perifollicular papules.Figure 23.4 White sclerotic plaques on labia majora.Figure 23.5 Localised lichen sclerosus of clitoral hood.Figure 23.6 Ecchymosis in lichen sclerosus.Figure 23.7 Perineal fissure in lichen sclerosus.Figure 23.8 Architectural change with resorption of labia minora, sealing of...Figure 23.9 Extra‐genital lichen sclerosus on thigh.Figure 23.10 Lichen sclerosus and vitiligo on lower labia majora.Figure 23.11 Clitoral pseudocyst.Figure 23.12 Squamous cell carcinoma (SCC) arising in lichen sclerosus.Figure 23.13 Algorithm for treatment of female lichen sclerosus.
23 Chapter 24Figure 24.1 Lichen planus – typical histological features with sawtooth rete...Figure 24.2 Hypertrophic lichen planus with marked hyperkeratosis and acanth...Figure 24.3 Involvement at other sites with lichen planus.Figure 24.4 Classic lichen planus with papules on the anterior labia majora....Figure 24.5 Hypertrophic lichen planus on left labium majus.Figure 24.6 Erosive lichen planus. Erosions with white lacy edge affecting v...Figure 24.7 Anterior and posterior fusion with active erosive lichen planus....Figure 24.8 Severe fusion secondary to lichen planus leading to pinhole meat...Figure 24.9 Vaginal involvement in erosive lichen planus.Figure 24.10 Erosive gingivitis in vulvovaginal‐gingival syndrome.Figure 24.11 Scarring of lacrimal duct secondary to lichen planus.
24 Chapter 25Figure 25.1 Hidradenitis suppurativa. Marked inflammation, including suppura...Figure 25.2 Hidradenitis suppurativa. Dense inflammatory infiltrate containi...Figure 25.3 Hidradenitis suppurativa: axillary involvement with abscesses an...Figure 25.4 Nodules, abscesses, and draining sinuses.Figure 25.5 Thickened scarring on mons pubis in hidradenitis suppurativa.
25 Chapter 26Figure 26.1 Direct immunofluorescence (DIF) in bullous pemphigoid – linear b...Figure 26.2 Bullous pemphigoid. Tense bullae on an erythematous base.Figure 26.3 Mucous membrane pemphigoid. Scarring can be similar to that of l...Figure 26.4 Histology of pemphigus vulgaris. IgG directed against desmosomes...Figure 26.5 Pemphigus vulgaris: adjacent to a fresh blister (where epitheliu...Figure 26.6 Pemphigus vulgaris: marked oedema, erosions, and ulceration.
26 Chapter 27Figure 27.1 Nodular prurigo. Intensely pruritic nodules on lichen simplex.Figure 27.2 Intertrigo in right inguinal fold.Figure 27.3 Major oral aphthous ulcer.Figure 27.4 Healing aphthous ulcer lower‐right labium majus.Figure 27.5 Behcet’s disease. Deep scarring ulceration on vulva.Figure 27.6 Vulval amyloidosis: atrophy and architectural change.Figure 27.7 Histological features of plasma cell vulvitis showing marked epi...Figure 27.8 Plasma cell vulvitis, red/orange discoloration in vestibule.Figure 27.9 Adenosis after toxic epidermal necrolysis. Erythema and pigmenta...
27 Chapter 28Figure 28.1 Junctional type epidermolysis bullosa showing extensive erosion ...Figure 28.2 Hailey‐Hailey disease histology. Acantholysis showing ‘dilapidat...Figure 28.3 Hailey‐Hailey disease. Moist, scaly erythema and papules on vulv...Figure 28.4 Ligneous disease:deep amorphous hyaline material. Courtesy of Dr...Figure 28.5 (a) White sponge naevus of the vulva. (b) White sponge naevus wi...
28 Chapter 29Figure 29.1 Post‐inflammatory hyperpigmentation after lichen planus.Figure 29.2 Histological features of melanosis with increased basal melanin ...Figure 29.3 Vulval melanosis. Dark pigmentation upper vestibule.Figure 29.4 Melanosis showing irregular and variable macular pigmentation.Figure 29.5 Histology of Dowling‐Degos disease. The epidermis shows branchin...Figure 29.6 Dowling‐Degos disease. Speckled pigmentation on labia majora.Figure 29.7 Vitiligo showing symmetrical loss of pigment.Figure 29.8 Poliosis affecting right labium majus.
29 Chapter 30Figure 30.1 Vulval acne. Inflammation and pustule in right interlabial sulcu...Figure 30.2 Fox‐Fordyce disease. Papules seen in flexures.Figure 30.3 Lichen‐planopilaris. Lichenoid papules and hair loss on mons pub...
30 Chapter 31Figure 31.1 Initial lesion of fixed drug eruption on arm.Figure 31.2 Swelling and blistering on vulva.Figure 31.3 Fixed drug eruption to co‐trimoxazole showing acute erythema, sw...Figure 31.4 SJS/TEN syndrome. Multiple vulval ulcers and erosion.Figure 31.5 SJS/TEN syndrome. Widespread superficial erosions.Figure 31.6 (a) Persistent fixed ulcer secondary to nicorandil.Figure 31.7 Erosive change upper vestibule secondary to Foscarnet.
31 Chapter 32Figure 32.1 Glucagonoma syndrome: scaly and moist serpiginous rash.Figure 32.2 Acanthosis nigricans: velvety thickening on inner thighs.Figure 32.3 Crohn’s disease: fissures and erosions.Figure 32.4 Deep fissuring in gluteal cleft.Figure 32.5 Crohn’s disease: ulceration and scarring.Figure 32.6 Graft‐versus‐host disease: vulval synechiae and labial fusion.
32 Chapter 33Figure 33.1 Secondary genital lymphoedema. There is pitting oedema of the mo...Figure 33.2 Labial lymphoedema and lymphangiectasia secondary to cervical ca...Figure 33.3 Noonan syndrome causing bilateral lower limb and genital lymphoe...
33 Chapter 34Figure 34.1 Arteriovenous malformation of right labium majus.Figure 34.2 Vulval varicosities.Figure 34.3 Engorged varicosities in vestibule in a patient who also has lic...
34 Chapter 36Figure 36.1 Factors involved in aetiology of vulvodynia.Figure 36.2 Anatomic structures of the vulva with the most painful area mark...
35 Chapter 38Figure 38.1 Epidermoid cysts both labia majora. Several angiokeratomas are a...Figure 38.2 Mucinous cyst lined by a single layer of columnar endocervical‐t...Figure 38.3 Fibroepithelial polyp with mildly cellular stroma and overlying ...Figure 38.4 Seborrhoeic keratose showing stuck on waxy papules.Figure 38.5 Seborrhoeic keratosis composed of bland basaloid cells and kerat...Figure 38.6 Verruciform xanthoma with papillary proliferations.Figure 38.7 Hidradenoma papilliferum. Small nodule in right interlabial sulc...Figure 38.8 Hidradenoma papilliferum with variable sized tubular glands.Figure 38.9 Apocrine metaplasia in hidradenoma papilliferum.Figure 38.10 Syringomas. Flesh‐coloured papules on labia majora.Figure 38.11 Syringoma with cystic glands in dermis.Figure 38.12 Glands lined by double layer of cells with comma‐like tails.Figure 38.13 Vulval leiomyoma. Well‐circumscribed lesion with bundles of smo...Figure 38.14 Angiomyofibroblastoma showing myxoid stroma, numerous small blo...Figure 38.15 Cellular angiofibroma with rich vascular network and several sm...Figure 38.16 Histology of lymphangiectasia showing dilated vessels lined by ...Figure 38.17 Angiokeratomas. Multiple vascular lesions on right labium majus...Figure 38.18 Angiokeratoma. Dilated vascular channels with hyperkeratosis of...
36 Chapter 39Figure 39.1 Atypical genital naevus. Irregular dark naevus on right labium m...Figure 39.2 Histological features of atypical genital naevus with nest of me...
37 Chapter 40Figure 40.1 (a) High‐grade squamous intraepithelial lesions (HSIL) histologi...Figure 40.2 HSIL. Positive high‐risk HPV.Figure 40.3 HSIL. Positive Ki‐67.Figure 40.4 HSIL. Polymorphic lesions with multiple warty lesions and some e...Figure 40.5 Extensive HSIL with hyperkeratotic area extending into vagina.Figure 40.6 Anal intraepithelial neoplasiaFigure 40.7 Pigmented HSIL. Lesions resembling seborrheic keratoses.
38 Chapter 41Figure 41.1 Differentiated VIN, thickened epidermis, and abnormal keratinocy...Figure 41.2 Differentiated VIN‐positive p53 staining in basal layers.Figure 41.3 (a) Differentiated VIN. Ulcerated with hyperkeratotic edge right...Figure 41.4 Small squamous cell carcinoma (SCC) arising in dVIN (glazed eryt...Figure 41.5 Differentiated VIN with invasive small squamous cell carcinoma (...
39 Chapter 42Figure 42.1 Non‐invasive vulval Paget’s disease, with typical clusters of Pa...Figure 42.2 Vulval Paget’s disease: erythema with erosions and areas of hype...Figure 42.3 Peri‐anal Paget’s diseaseFigure 42.4 Vulval Paget’s disease of the interlabial sulcus and right inner...
40 Chapter 43Figure 43.1 Overview of the multistage evolution of vulval squamous cell car...Figure 43.2 (a) Vulvar squamous cell carcinoma (VSCC) on the background of l...Figure 43.3 Invasive squamous cell carcinoma (SCC) arising from a plaque of ...Figure 43.4 Moderately differentiated large‐cell keratinising carcinoma with...Figure 43.5 Low magnification of early invasive squamous carcinoma with push...Figure 43.6 Verrucous carcinoma with extensive warty vulval plaque.Figure 43.7 (a) A 55‐year‐old patient developed on the background of multifo...Figure 43.8 Examples of fasciocutaneous flaps that may be used for perineo‐v...
41 Chapter 44Figure 44.1 Ulcerated nodular melanoma.Figure 44.2 In situ melanoma histological features with cytological atypia....Figure 44.3 Vulval melanoma with irregular pigmentation and nodular areas.Figure 44.4 Extensive nodular malignant melanoma with amelanotic areas.Figure 44.5 In situ melanoma with very subtle pigmentation affecting glans c...
42 Chapter 45Figure 45.1 Vulval basal cell carcinoma. Pearly nodule on right labium majus...Figure 45.2 Superficial basal cell carcinoma with peripheral palisading aris...Figure 45.3 Morphoeic basal cell carcinoma with infiltrating tumour cords.Figure 45.4a Dermatofibrosarcoma protruberans with extensive replacement of ...Figure 45.4b Dermatofibrosarcoma protruberans. Lace‐like infiltration of the...Figure 45.5 Aggressive angiomyxoma. Hypocellular myxoid lesion in the subcut...Figure 45.6 Aggressive angiomyxoma. Replacement of the fat, and few bland, s...Figure 45.7 Vulval epithelioid sarcoma. Sheets of tumour cells often without...Figure 45.8 Vulval epithelioid sarcoma. Large, pleomorphic epithelioid cells...Figure 45.9 Adenoid cystic carcinoma composed of infiltrating nests punctuat...Figure 45.10 Adenoid cystic carcinoma composed of anastomosing trabeculae wi...Figure 45.11 Merkel cell carcinoma. Proliferation of small cells below the s...Figure 45.12 Merkel cell carcinoma. Ill‐defined cords of small cells with sc...Figure 45.13 Primary marginal zone lymphoma of the vulva. Nodule left labium...
43 Chapter 46Figure 46.1 Types of female genital mutilation.Figure 46.2 The surgery step by step: 1. Removing the scar tissue. 2. Dissec...Figure 46.3 Clitoral reconstruction immediately post‐operatively.Figure 46.4 Clitoral reconstruction 6 months post‐operatively.
44 Chapter 49Figure 49.1 Irritant eczema affecting convex labia majora.Figure 49.2 Extensive psoriasis with maceration in inguinal folds and fissur...Figure 49.3 Prepubertal lichen sclerosus, symmetrical pallor with haemorrhag...Figure 49.4 Lichen sclerosus with marked ecchymosis.Figure 49.5 Lichen sclerosus with hyperkeratosis and some oedema.Figure 49.6 Vulval vitiligo.Figure 49.7 Lichen sclerosus and vitiligo occurring together.Figure 49.8 Linear IgA disease – clustered bullae of the lower abdomen and g...Figure 49.9 Acrodermatitis enteropathica with bright red erythema.
45 Chapter 50Figure 50.1 Perianal streptococcal infection in a male child.Figure 50.2 Ecthyma gangrenosum due to Pseudomonas infection.Figure 50.3 Genital herpes simplex.
46 Chapter 51Figure 51.1 Anterior labial adhesions.Figure 51.2 Fibrotic hymenal membrane.
47 Chapter 52Figure 52.1 Hair tourniquet affecting left labium minus with superficial nec...
48 Chapter 54Figure 54.1 Radial tear in right labium minus.Figure 54.3 Labial detachment.Figure 54.2 Perforation in left labium minus.Figure 54.4 Midline fissuring.Figure 54.5 Scarring after fissuring at right posterior vestibule.Figure 54.6 Mechanical hymenal fissure of hymenal ring at 9 o’clock.Figure 54.7 Late radiation effects with telangiectasia and fibrosis.Figure 54.8 Frictional keratosis in left anterior vulval vestibule.Figure 54.9 Cyclist’s vulva: unilateral swelling of left labium majus.
49 Chapter 55Figure 55.1 Folliculitis on mons pubis after shaving.Figure 55.2 Large vulval keloid after shaving injury.Figure 55.3 Purpura in inguinal folds after waxing.Figure 55.4 Genital piercing of clitoral hood.
