Clock-face cells in the vulva: Clue to a timely diagnosis

Plasma cell vulvitis is a chronic benign inflammatory disorder of the female genital mucosa which is refractory to therapeutic modalities. An accurate diagnosis and timely intervention is necessary as it may mimic other genital dermatoses. Clinically, it is characterized by a well-circumscribed, shiny, erythematous patch or plaque involving the genital mucosa. Histopathological assessment is indispensable for diagnosis. Typical microscopic features include lozenge-shaped keratinocytes, the presence of siderophages, foci of hemorrhage, and a variable plasma cell infiltrate within the dermis. Therapeutic response to topical agents alone is often unsatisfactory; however, laser-based and surgical modalities have demonstrated efficacy in achieving sustained remission.