In patient with Vulval ulcer. Which of the following will lead to malignancy?

Ans. (d) HPVRef. William's Gyenecology Ch 31HPV (16, 18) most comman cause of vulvar carcinoma.* HPV infects the female - vulva, vagina, and cervix* Male- urethra, penis, and scrotum.* Both genders -Perianal, anal, and oropharyngeal area.Salient Features of Vulvar CancerMC site- labia majora and minoraMC symptom pruritus.MC type- SCC, epidermoid type (same for vaginal CA)MC implicated factor- HPV 16,18.Premalignant lesion of vulva * VIN (MC) vulvar intraepithelial lesion* /ts ds* Condyloma accuminata* Lichen sclerosis* Erythroplasia of querat* Bowen disease (type of VIN)MC mode of spread- lymphatic1st LN- superficial inguinal LN2nd LN- deep inguinal LN