The Vulvar Dermatoses

Abstract

Introduction Dermatologic diseases of the vulva may cause dyspareunia. These disorders may be overlooked by gynecologists and urologists because of lack of residency training experience. Dermatologists who are most familiar with these diseases are infrequently trained in vulvovaginal examination. As such, these disorders are often improperly diagnosed and treated. Aim To describe the presentation and management of the major vulvar dermatoses including irritant and allergic contact dermatitis, lichen sclerosus, lichen simplex chronicus, and lichen planus. Main Outcome Measure Data from a peer review literature search on the topic of vulvar dermatoses. Methods The literature for this review article was obtained through a Medline search. Appropriate dermatology textbooks were utilized for additional information. Results A comprehensive survey of the vulvar dermatoses. Conclusion Vulvar dermatoses must be considered a part of the differential diagnosis of any woman with a sexual pain disorder. As such, healthcare providers who evaluate and treat women with dyspareunia must become familiar with the most common dermatologic disorders of the vulva.

A double-blind, randomized controlled trial of clobetasol versus pimecrolimus in patients with vulvar lichen sclerosus

“…The typical lesions of LS are white plaques and papules, often with areas of ecchymosis, excoriation, and ulceration. 3 The histopathologic changes of LS are distinctive with pathognomonic findings on a biopsy specimen. Characteristic pathologic finding include hyperkeratosis of the epidermis, epidermal atrophy with loss of rete ridges, homogenization of the collagen in the papillary dermis, and a lichenoid (bandlike) inflammatory infiltrate in the dermis.…”

Is it relevant a correct intimate cleansing in the treatment of vulvar dermatosis?

“…the posterior fourchette [7]. The typical lesions are porcelain-white papules and plaques with follicular delling and hyperkeratosis.…”

“…It is thought to be an atopic disorder in many cases and may also arise in normal skin [6]. In both the disorders, the area involved may vary from a single small to the entire region of vulva, perineum, and perianus [7]. The primary lesions of vulvar dermatosis are white/red, flat and/or thickened areas.…”

Les dyspareunies organiques

“…Elles s'associent à un prurit, des brûlures vaginales, des leucorrhées pathologiques, des lésions dermatologiques. Un traitement adapté permet le plus souvent la sédation de la dyspareunie ; les lésions dermatologiques de type lichens, aphtose, VIN3 (la maladie de Bowen et la papulose bowé-noïde…), psoriasis [3] ; origine allergique, iatrogène (toilettes répétées, utilisation intempestive de tampons, etc. ).…”