Vulval and perianal intraepithelial neoplasia: response to chemoradiotherapy in a woman with idiopathic CD4 lymphocytopenia

Treatment of multicentric or multifocal anogenital intraepithelial neoplasia is challenging, especially if the patient has immunodeficiency. We report the case of a woman with idiopathic CD4 lymphocytopenia and vulval and perianal intraepithelial neoplasia with early invasive disease, who responded well to radiotherapy combined with chemotherapy. Chemoradiotherapy is often used in the primary treatment of anal carcinomas, but has rarely been reported as a treatment for premalignant anogenital conditions.