Reviewer’s report
Title: 
Vulvar Crohn’s Disease in an adolescent diagnosed after unsuccessful
surgical treatment: A case report
Version: 
0 
Date: 
18 Jun 2021
Reviewer: 
Filippo Alberto Ferrari
Reviewer's report:
Dear Respectable Editor
I am grateful to give me the opportunity to review the manuscript entitled
"Vulvar Crohn's Disease in an adolescent diagnosed after unsuccessful surgical
treatment: A case report".
Vulvar Crohn's disease (VCD) is an uncommon extraintestinal localization.
Symptoms are variable and uncommonly, as in the reported case report,
gastrointestinal tract is involved in asymptomatic way.
The authors presented a complete abstract and informative title. I appreciated the
novelty given to scientific literature for a such rare gynecological disease. In the
Background section at line 5 the authors reported diarrhea as a representing
symptom of CD but this is one of the possible presentations and not the most
frequent. I suggest to clarify this point and consider this paper: DOI
10.1016/j.crohns.2014.05.006.
In Background section I suggest to report the incidence of the two VCD
mentioned by the authors or the absence of this statistical data if unreported in
literature (line 12). The authors performed a literature search of the most notable
available papers. In my opinion, a Table summarizing relevant information about
presentation, radiological findings (if reported) and management could provide a
useful tool in everyday clinical practice. Case report is precisely reported and
clear in every diagnostic and therapeutic phase. Figures and titles are acceptable.
Discussion is well conducted but I advice to consider the possible role of VCD in
vulvar cancer development (DOI: 10.1016/0002-9378(77)90067-9; PMCID:
PMC5100894). Considering the most important prognostic factors of vulvar
cancer (consider these papers: DOI: 10.1016/j.ejso.2019.07.029; DOI:
10.1111/jog.14368) I suggest to stress the possibility of biopsy or histological
analysis of the excised tissue in case of doubtful clinical presentation in order to
not miss malignant lesions.
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