Idiopathic granulomatous inflammation of the female genital tract: a separate entity?

CASE: A 35-year-old woman had recurrent, histologically confirmed idiopathic granulomatous inflammatory lesions involving the vulva, anoperineum, vagina, and cervix. This is the first report of involvement of the entire lower female genital tract in this pathological process. The disease has clinical and histological characteristics similar to the genital manifestations of Crohn's disease and the MelkerssonRosenthal syndrome (cheilitis granulomatosa of Miescher). In some cases, vulvitis granulomatosa has a temporal relationship with both of these clinical entities.

CONCLUSION: These three diseases-Crohn's disease, the Melkersson-Rossenthal syndrome, and vulvitis granulomatosa-could reflect identical granulomatous disease, but do not necessarily result from a common etiological factor. The treatment of these conditions remains surgical excision with or without intralesional corticosteroid injections.