Vulvar psoriasis in an adolescent girl: Diagnostic difficulties and the need for a multidisciplinary approach

This article presents a clinical case of vulvar psoriasis in a 15-year-old girl. It explains the potential for diagnostic errors in this particular area of the disease and substantiates the feasibility of simultaneous observation by a dermatovenerologist and an obstetrician-gynecologist. A retrospective analysis of the patient’s medical history was conducted, as she presented with perineal itching. An examination by two specialists was performed, and a vulvar skin biopsy was performed, followed by histological processing (hematoxylin and eosin, Schiff reagent, and Grocott staining). Literature describing genital forms of psoriasis was also reviewed. The skin of the groin, perineum, and inner thigh had hyperemic lesions with silvery scaling and a clear border. Microscopic examination of the biopsy specimen revealed acanthosis, parakeratosis, zones of varying granular layer thickness, spongiosis, lymphocyte migration into the epidermis, and perivascular infiltrates. A pathologist noted a possible histological correspondence with psoriasis. Comparison of the clinical presentation and histological findings led to a diagnosis of vulvar psoriasis. Treatment included topical glucocorticosteroids and narrowband phototherapy (UVB 311 nm), which resulted in positive dynamics. Vulvar psoriasis is rare in adolescents and is often missed due to its similarity to other dermatoses. Involving physicians from various specialties reduces the examination time, eliminates unnecessary therapy, and enables the selection of treatment with a lasting effect. This case report confirms the importance and necessity of an interdisciplinary approach.