Macroscopic and microscopy findings at diagnosis: (a): vulvar bleeding vegetants lesions; (b): micropapillary pattern; (c): acantholysis and mitosis. Early invasive vulvar squamous cell carcinoma arising in a woman with vulvar pemphigus vulgaris and systemic lupus erythematosus. Bifulco G, Mandato VD, Piccoli R, Giampaolino P, Mignogna C, Mignogna MD, Costagliola L, Nappi C - BMC cancer (2010). Not Altered. CC.