The vulva is skin, and it is helpful to approach vulval conditions from a dermatological perspective. The vulva is affected by the same dermatoses as the rest of the skin, but modified in appearance by special influences.
This article will outline an approach to the diagnosis and management of vulval dermatoses.
Vulval disorders present as infections, rashes and lesions, and pain. This article considers inflammatory vulval disorders that present as erythematous rashes, pallor or erosions and ulcers. Most vulval dermatoses are recurrent or chronic and may require maintenance therapy. Chronic painful and itchy vulval conditions can lead to secondary pelvic floor spasm and a sensory neuropathy. Many vulval disorders are multifactorial and can benefit from a multidisciplinary approach to management.
Vulval medicine spans dermatology, gynaecology and sexual health. Many conditions affecting the vulva are dermatological, modified by anatomical, hormonal and microbiological influences. Dermatoses that affect the vulva are the same as those that affect the rest of the skin, but the appearance is modified by the environment which produces heat, friction and occlusion. Vulval disorders present as infections, rashes, lesions and pigmentation, and pain. This article considers inflammatory vulval dermatoses that present as rashes that are erythematous, pale or erosive (Table 1).
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