Original StudyVulvar Elastosis: A Novel Diagnostic EntitySee, Sharlene Helene C. MD*; Tan, Timothy L. DO†; Kurtzer, Traci A. MD‡; Gerami, Pedram MD†; Guitart, Joan MD†; Yazdan, Pedram MD† Author Information *Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL; †Department of Dermatology, Division of Dermatopathology, Northwestern University Feinberg School of Medicine, Chicago, IL; and ‡Department of Obstetrics and Gynecology, Northwestern Memorial Hospital, Chicago, IL. Correspondence: Pedram Yazdan, MD, Department of Dermatology, Northwestern University, 676 N, St. Clair Street, Suite 1600, Chicago, IL 60611 (e-mail: [email protected]). The authors declare no conflicts of interest. IRB approval status: Reviewed and approved by Northwestern University Institutional Review Board. The American Journal of Dermatopathology: June 2021 - Volume 43 - Issue 6 - p 418-422 doi: 10.1097/DAD.0000000000001862 Buy Metrics Abstract In vulvar biopsies, we have observed histopathologic abnormalities of elastic fibers identical to solar elastosis, with thick, curled, and irregular pale grey fibers in the dermis. In severe cases, changes resemble nodular solar elastosis. We retrospectively evaluated 238 vulvar biopsies with the goal of defining and characterizing changes of vulvar elastosis. Of 238 vulvar biopsies reviewed, 107 (45%) exhibited vulvar elastosis. Patients with vulvar elastosis were older (mean = 65 years old) compared to those without (mean = 44 years old). Sixty-six (62%) were graded as mild, 27 (25%) moderate, and 14 (13%) severe. Vulvar elastosis was significantly more common in women ≥45 years old (P-value < 0.001). There was moderate correlation between age and severity (correlation coefficient = 0.55, P-value < 0.001). Vulvar elastosis was observed in a variety of inflammatory and non-inflammatory pathologies. In 5 cases, the sole pathology was vulvar elastosis presenting clinically as either a pruritic or painful white to white-yellow papule or plaque, or vulvar pain or burning without a clinical lesion. Vulvar elastosis is a novel diagnostic entity occurring in a sun-protected site and its pathogenesis may be a degenerative phenomenon possibly related to advancing age and/or hormonal changes. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.