Question 1:
The patient is a 45-year-old woman who presents with multiple scaly papules and plaques on her vulva bilaterally. She endorses mild pruritus in the area, but review of systems is otherwise negative. Further skin examination is unremarkable. She is otherwise healthy and has no known family history. Biopsy of one of the lesions reveals the following histopathology (Figure 1-3):
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Figure 1.
Figure 2.
Figure 3.
What is the best diagnosis?