New SBAs and EMQs on Vulval Conditions

A 34-year-old woman attends the vulval clinic with a 6-month history of a persistent vulval lesion associated with mild pruritus. She is a smoker and has a history of cervical high-risk HPV infection. On examination, there is a well-defined, slightly raised hyperpigmented plaque on the right labia minora. There is no ulceration or induration. A vulval biopsy is performed. The histology shows basal layer atypia with high nuclear-to-cytoplasmic ratios, hyperchromasia, pleomorphism, cytological atypia and mitoses without stromal invasion. What is the likely diagnosis?

A 68-year-old postmenopausal woman presents with long-standing vulval itching and soreness. She has a background of biopsy-proven vulval lichen sclerosus treated intermittently with topical corticosteroids. Examination reveals a poorly defined, thickened pale area with focal erythema on the labia majora. A punch biopsy is performed due to concern about malignant transformation. The histology shows basal layer atypia with acanthosis, occasional parakeratosis, and irregular elongation and anastomoses of the rete ridges without stromal invasion. A diagnosis of differentiated vulvar intra-epithelial neoplasia is made.  What is the risk of malignant transformation to squamous cell carcinoma?