••• CHAPTER 31^ Benign Vulvar and Vaginal Lesions^301
❍ What is a complication of Skene duct cysts?
Urinary obstruction due to enlargement.
❍ The Gartner duct arises from what structure?
Vestigial remnant of the vaginal portion of the mesonephric duct (Wolffian duct).
❍ How do Gartner duct cysts usually appear?
Multiple tiny cystic dilations, most commonly, or rarely as a large single cyst in the anterolateral vaginal wall.
❍ Where does endometriosis most commonly appear in the vagina?
Posterior fornix as a result of penetration from the cul-de-sac.
❍ What is vaginal adenosis and what is it associated with?
Presence of epithelial lined glands or their secretory products within the vagina and is associated with in utero
exposure to DES.
❍ What are the examination findings of atrophic vaginitis?
Vaginal mucosa is thin and pale with lack of normal rugae and often with visible blood vessels or petechial
hemorrhages.
❍ What does a wet mount show with atrophic vaginitis?
Small rounded parabasal epithelial cells with an increased number of PMNs.
❍ What other inflammatory condition are parabasal cells seen on wet mount?
Desquamative inflammatory vaginitis.
❍ What are the symptoms of inflammatory desquamative vaginitis?
Profuse purulent discharge, vaginal burning and pain, and dyspareunia.
❍ What is the treatment of desquamative inflammatory vaginitis?
Clindamycin cream and hydrocortisone cream per vagina.
❍ What is a autoimmune disease causing ulcer like lesions in premenopausal women in the vagina and mouth?
Behcet disease.
❍ What systemic disease can present with lacy macular rash with areas of ulceration on the vulva?
Lichen planus.
❍ What does lichen planus look like?
Violet, pruritic, polygonal papules or plaques (can also be bullous and ulcerate).