Clinical and epidemiological profile of patients attended in a vulvar clinic of the dermatology outpatient unit of a tertiary hospital during a 4‐year period

Abstract

Background Vulvar complaints are among the most frequent causes for a woman to visit a healthcare provider. The diseases of this area of the body may be a challenge to diagnose. In this study, we assess epidemiologic and clinical data of patients in an outpatient vulvar clinic in the dermatology department of a tertiary hospital. MethodsWe performed an observational retrospective study of patients who attended our consultation service for vulvar diseases at the Dermatology Division at Hospital das Cl ınicas da Faculdade de Medicina da USP during a 4-year period. Data were obtained by patient medical records and by phone.Results During the 4-year period under study, a total of 136 patients were treated in the outpatient service specialized in vulvar care. All patients were included in the study. The most frequent diagnoses were lichen sclerosus et atrophicus (64.7%), lichen planus (8.8%), and vitiligo (8%). We registered that 26.7% of the patients showed extravulvar involvement.Conclusions Women with vulvar diseases need specific care, considering not only genital aspects but also all skin changes. In this context, the dermatologist is a very well trained professional to take good and complete care of these patients. However, ideally vulvar clinics should have a multidisciplinary team.

Vulvar dermatoses: a cross-sectional 5-year study. Experience in a specialized vulvar unit

“…In fact, other studies similar to ours, and which were carried out by dermatologists, have reported a similar percentage of infections. 8 , 9 In the same way, the various inflammatory diseases that involved the vulva – and which were so prevalent in our consultations – included atopic dermatitis, psoriasis, or hidradenitis suppurativa ( Fig. 8 ).…”

“…This was followed by irritative eczema and lichen simplex chronicus, like other series. 8 , 9 , 10 This type of practice has experienced an increase in the number of patients seen each year, especially in the last 2 years. In fact, in the 2018–2020 period, 89.2% of the women in our series attended a consultation for the first time.…”

“…11 Its true prevalence is unknown and varies depending on whether it is assessed by specialists in gynecology or dermatology. 8 However, its incidence seems to be increasing and it is one of the most frequent diagnoses in vulvar consultations, 12 although this could also be the result of an increase in consultations and in the number of diagnoses. In our series, lichen sclerosus represented 41.9% of the total diseases identified, making it the most frequently identified disease, similar to what has been reported in other studies.…”

“…In our series, lichen sclerosus represented 41.9% of the total diseases identified, making it the most frequently identified disease, similar to what has been reported in other studies. 8 , 9 , 10 Irritant eczema and lichen simplex chronicus are common dermatoses in the general population that frequently involve the vulva. Among the causes of both dermatoses, it is important to inquire into all products that have been applied topically to the vulva; clinicians should also inquire about intimate hygiene habits, and ask if the patient has been experiencing any type of incontinence.…”

The Genital Examination in Dermatologic Practice

“…18 We also should not forget that inflammatory conditions can routinely involve the genitals. [19][20][21] Although robust data are lacking, chronic vulvar concerns frequently are seen in the primary care setting. In one study in the United Kingdom, 52% of general practitioners surveyed saw more than 3 patients per month with vulvar concerns.…”