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A 47-year-old woman presented with a large, gray, verrucous plaque rapidly growing on the vulva for 8 months. Histopathologically, the lesion showed a marked hyperkeratosis, acanthosis, papillomatosis, and dysregulated epidermal hyperplasia with atypical hyperchromatic cells. The basement membrane zone remained intact. Human papilloma virus type 16 and 18 was detected in the lesional area by in situ hybridization. Based on these findings, the lesion was identified as vulvar intraepithelial neoplasia (VIN). Although vulvar lesions are examined by both dermatologists and gynecologists, their diagnostic jargon of the verrucous, hyperplastic plaque that shows intraepithelial neoplasia, is not always concordant. We believe that VIN could be a better substitute for large bowenoid papulosis, Bowen’s disease or vulvar erythroplasia of Queyrat.
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