Parallel pathologies? Vulvar vestibulitis and interstitial cystitis.

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.