E G Stewart1, B M Berger. 1. Stewart-Forbes Specialty Service, Harvard Pilgrim Health Care, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: To determine if epithelial defects found only with periodic acid-Schiff/colloidal iron staining and Van Gieson counterstaining of the bladder in interstitial cystitis (IC) exist in the vulva in vulvar vestibulitis syndrome (VVS) and to determine if immunofluorescence seen in IC exists in VVS. STUDY DESIGN: Vulvar biopsies from 16 prospective and 16 retrospective cases of VVS were stained with Van Gieson stain, as were 30 controls of normal vulvar vestibule from biopsies obtained for benign lesions. Sixteen prospective vulvar biopsies from patients with VVS were evaluated for immunofluorescence. RESULTS: No obvious epithelial defects were found with Van Gieson staining in VVS. Three cases were eliminated for diagnoses other than VVS. Nine of 13 cases showed + to +3 complement (P = .0000005). Seven of 13 showed +IgM (P = .0000005). CONCLUSION: Vulvar epithelium stained with Van Gieson stain did not show defects in VVS but did show complement deposition along the dermoepithelial junction and perivascular IgM. Vascular injury associated with altered central neuronal processing could mediate the positive immunofluorescence findings in both VVS and IC.
OBJECTIVE: To determine if epithelial defects found only with periodic acid-Schiff/colloidal iron staining and Van Gieson counterstaining of the bladder in interstitial cystitis (IC) exist in the vulva in vulvar vestibulitis syndrome (VVS) and to determine if immunofluorescence seen in IC exists in VVS. STUDY DESIGN: Vulvar biopsies from 16 prospective and 16 retrospective cases of VVS were stained with Van Gieson stain, as were 30 controls of normal vulvar vestibule from biopsies obtained for benign lesions. Sixteen prospective vulvar biopsies from patients with VVS were evaluated for immunofluorescence. RESULTS: No obvious epithelial defects were found with Van Gieson staining in VVS. Three cases were eliminated for diagnoses other than VVS. Nine of 13 cases showed + to +3 complement (P = .0000005). Seven of 13 showed +IgM (P = .0000005). CONCLUSION: Vulvar epithelium stained with Van Gieson stain did not show defects in VVS but did show complement deposition along the dermoepithelial junction and perivascular IgM. Vascular injury associated with altered central neuronal processing could mediate the positive immunofluorescence findings in both VVS and IC.