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Idiopathic chronic granulomatous vulvitis and related diagnostic and treatment conundrum
  1. Smrati Sabnani1,
  2. Amrita Gaurav1,
  3. Nishank Manohar2 and
  4. Shweta Azad3
  1. 1Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  2. 2Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  3. 3Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  1. Correspondence to Dr Amrita Gaurav; aamrity{at}


Three years ago, a woman in her late 30s presented with huge masses in the lower genital tract region, including bilateral labia majora, labia minora and the gluteal region. The patient had had many antimicrobial, antiprotozoal, steroid and topical antibiotic treatments. The patient was misdiagnosed and treated for metastatic Crohn’s disease, but there was no improvement. The patient underwent extensive local excision of the lesions and was identified with a deep aggressive angiomyxoma; however, the tumors recurred. Her clinical condition deteriorated, and she was brought to this institution. This area was biopsied, and the results were suggestive of non-necrotising granulomatous disease. Labial and gluteal lesions were surgically excised, followed by primary closure of the operative site. The patient has undergone regular monitoring and has not experienced a recurrence.

  • Obstetrics and gynaecology
  • Dermatology

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  • Contributors SS, AG, NM and SA have been actively involved in this patient’s management and care. SS and AG have formulated the manuscript. NM and SA have proofread the manuscript and added valuable suggestions. All the authors have read and agreed to the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.