case_images: PMC11233039_01
case_images: (a-c) Vulvar edema, erythema with multiple herpetiform erosions
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case_images: On cutaneous examination, there was symmetrical tender vulvar swelling with multiple superficial tender herpetiform ulcers with an indurated base and jagged borders, along with perianal ulcers and tags [Figures 1a-c and 2].
case_images: Perianal erosions and skin tags
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case_images: On cutaneous examination, there was symmetrical tender vulvar swelling with multiple superficial tender herpetiform ulcers with an indurated base and jagged borders, along with perianal ulcers and tags [Figures 1a-c and 2].
case_images: (a and b) Edematous and erythematous gingivae
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case_images: The oral cavity showed slightly erythematous, edematous upper, and lower gingivae without ulcers [Figure 3a and b].
case_images: Knife like fissures over vulva seen as the disease progressed
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case_images: However, she presented to us within a year with tender indurated vulvar swelling, deep knife-like fissuring and linear ulcers over bilateral labia minora, ranging from 1 to 2 cm in length, which have been described as typically seen in cases of vulvar CD [Figure 4]; along with perianal fissuring, maceration and fissuring over groins, and axillae [Figure 5].
case_images: (a and b) Fissuring and maceration over groins and axillae seen as the disease progressed
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case_images: However, she presented to us within a year with tender indurated vulvar swelling, deep knife-like fissuring and linear ulcers over bilateral labia minora, ranging from 1 to 2 cm in length, which have been described as typically seen in cases of vulvar CD [Figure 4]; along with perianal fissuring, maceration and fissuring over groins, and axillae [Figure 5].
case_images: Histopathological examination showing granulomatous inflammation with multinucleated giant cells of foreign body type
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case_images: A repeat skin biopsy from the vulvar ulcers showed granulomatous inflammation with multinucleated giant cells, histiocytes, lymphocytes, and plasma cells [Figure 6].
case_images: (a and b) Resolution of erosions after treatment with residual window-like defect in labia minora
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case_images: She was treated with monthly methylprednisolone pulse along with oral prednisolone, sulfasalazine, and colchicine, with adequate remission and residual window-like defect in labia minora, [Figure 7a and b] however, with relapsed episodes.