The effect of topical pimecrolimus on inflammatory infiltrate in vulvar lichen sclerosus.

OBJECTIVE: Lichen sclerosus (LS) is a relatively common chronic inflammatory disorder of the skin and mucosal surfaces. STUDY DESIGN: A total of 29 women with histologically confirmed, active LS were recruited to this study with 2 aims. First, we evaluated the effectiveness of pimecrolimus treatment to LS not responding to conventional corticosteroid treatment. The second aim in this study was to provide information of in vivo effects of topical pimecrolimus in acute LS lesions, especially the inflammatory cell infiltration. RESULTS: In all, 25 of 29 women applied cream as recommended. After 2 months of treatment, 20 patients had reached partial or complete clinical remission. Histology showed decreased inflammatory lymphoid infiltrate with down-regulation of CD3(+) T cells, CD8(+) T cells, and CD57(+) natural killer cells. Also macrophage marker CD68 staining showed down-regulation. There was no change in CD20(+) B lymphocytes. CONCLUSION: We conclude that calcineurin inhibitors are an effective treatment for patients not responding to corticosteroid treatment.

Primary sex cord-like variant of endometrioid adenocarcinoma arising from endometriosis.

Endometriosis, a relatively common disease generally affecting women in the reproductive age group, is mostly found in the pelvic organs. Although endometriosis is a benign disease, some malignant tumors have been reported to develop in endometriotic lesions, most commonly in the ovary. The relationship between endometriosis and malignancy is not well known, but the majority of endometriosis-associated ovarian malignancies are usually endometrioid adenocarcinomas and clear cell carcinomas. The sex cord-like variant of endometrioid adenocarcinoma is a rare tumor that histologically closely resembles the sex cord-stromal tumor. Despite its rarity, the correct histological diagnosis of the sex cord-like variant of endometrioid adenocarcinoma is crucial to avoid misdiagnosis of a less aggressive tumor. We here report a 53-year-old woman who was diagnosed as having this very rare subtype of endometroid adenocarcinoma curiously arising from an endometriotic lesion at the site of previous salpingo-oophorectomy. The tumor was diagnosed based on light microscopy and immunohistochemistry.