Multinucleated Atypia of the Vulva

Multinucleated atypia of the vulva (MAV) is an entity with a distinctive histologic pattern of multinucleation in the basal and middle layers of the squamous epithelium that may mimic human papillomavirus (HPV)–related squamous atypias. MAV is rarely reported in the literature, and we believe it should be considered in the differential diagnosis of flesh-colored vulvar papules and vulvar epidermal atypias with multinucleated squamous cells. We describe the case of a 49-year-old patient with the diagnosis of MAV. Results of histopathologic examination revealed a focal area of multinucleation in the basal to middle epithelial layers of the vulvar squamous epithelium, accompanied by mild hyperkeratosis and chronic inflammation. HPV was not identified in the lesion by in situ hybridization techniques.