Plasma cell vulvitis: A case report

Plasma cell vulvitis (PCV) is a rare inflammatory condition characterised by plasma cell infiltration in the vulva. A woman in her 80s was referred to a specialist gynaecology clinic with chronic, painful vulval ulcers that were non-responsive to topical betamethasone. Following a biopsy confirming PCV, combination therapy was initiated. This included non-pharmacological management, such as promoting aeration and using hypoallergenic clothing and washes, combined with the daily application of clobetasone cream 0.05% and clindamycin cream 0.1%. Additionally, topical estriol 1% was applied twice weekly. The patient experienced rapid symptom resolution, with the PCV lesion healing within six weeks of starting treatment. This case documents the rare occurrence of plasma cell vulvitis presenting as chronic vulval ulceration, and proposes a treatment regimen worth considering in instances where monotherapy has been ineffective. •Long-standing misdiagnosed aphthous ulcers with failed betamethasone topical treatment.•Plasma cell vulvitis was confirmed on biopsy, with a high density of plasma cells.•The patient's condition responded well to a combination regime of clobetasone 0.05%, clindamycin 0.1% creams, and topical estriol cream 1%.•Complete resolution had been achieved at 6-week follow-up.