Clinical and Epidemiological Profile of Vulvar Lesions in a Tertiary Care Hospital in Mexico: An Overview of Malignant and Premalignant Lesions

Background: In recent years, various authors have reported an increase in vulvar cancer incidence, often preceded by premalignant vulvar lesions, which are now affecting younger women with concurrent factors such as smoking, immunosuppressive states (e.g., HIV), and post-transplant conditions. These premalignant lesions are defined as physical and biochemical factors that affect the vulvar epithelium and may progress to malignancy if not diagnosed and treated promptly. While vulvar cancer incidence rises with age, the average age has recently decreased, particularly among women aged 45 to 60. The GLOBOCAN database reported a prevalence of vulvar cancer in Central America at 2.02/100,000 persons, with 1166 cases in Mexico over five years. However, current clinical-epidemiological data from the Mexican population are lacking. Materials and Methods: This descriptive, retrospective, and cross-sectional study was conducted at the High Speciality Medical Unit of the Gynaecology-Obstetrics Hospital, National Medical Center of the West (UMAE HGO CMNO), where data were collected from 156 patient files in the dysplasia clinic. Clinical and sociodemographic data such as age, marital status, education level, smoking history, sexual orientation, comorbidities, physical examination findings, and biopsy results were analyzed using SPSS v.23 and Excel databases. The study was approved by the ethics committee of UMAE HGO CMNO, with no risks to patients due to the descriptive and retrospective nature of the study. Results: The study included 156 patients who met the inclusion criteria, with clinical and sociodemographic data collected from electronic and physical patient records. Various types of vulvar lesions were identified, categorized into four groups: benign, malignant or vulvar intraepithelial neoplasias (VIN), infectious, and inflammatory. Malignant lesions, particularly VIN, represented the most common etiology, accounting for 41% of the total sample. The majority of patients (62.12%) were between 19 and 50 years old, with a mean age of 38.57 years. The most common comorbidities were hypertension (23.44%), diabetes (17.19%), and immunological diseases (12.50%). The presence of HPV in the cervix was found in 26.56% of cases. Discussion: The aim of this study was to establish a clinical-epidemiological profile of patients with vulvar lesions in our region, providing insight into the frequency and characteristics of such lesions. This is particularly relevant as there is limited literature in Mexico addressing risk factors and clinical manifestations of vulvar lesions. Our findings align with international studies reporting an increase in vulvar cancer, primarily linked to HPV infection, immunosuppressive states, and smoking. The most frequent age group in our study was women in their fertile years, similar to reports from other Latin American countries. Despite the known association with HPV, our study highlighted a low use of barrier methods among patients. Conclusions: Vulvar pathology remains under-studied in Mexico, despite a growing incidence of vulvar cancer globally, often stemming from precursor lesions like VIN, which are mostly linked to HPV. This study’s findings reflect a similar epidemiology to international reports. Given the association with HPV, it is crucial to implement targeted screening and awareness strategies for the timely detection and treatment of premalignant lesions. This will improve the management of vulvar pathology and help healthcare professionals address this issue in our population effectively