Vulval Dermatoses
Lichen Simplex
Contact Dermatitis
Lichen Sclerosus
Lichen Planus
Lichen Simplex
The vulva may be involved as part of a generalised eczema or as a local area of chronic prurigo. Treat as for eczema.
Contact Dermatitis
Contact allergens such as cosmetic or fragranced products may lead to a contact sensitivity. Such patients need referring for patch testing.
Lichen Sclerosus
In the patient with an itchy vulva, look carefully for signs of lichen sclerosus with white atrophic areas and telangiectasia. There is sometimes scarring with architectural disruption such as labial resorption. If lichen sclerosus is suspected, treat with Dermovate ointment (bd for 1 month). If no improvement seen, refer to dermatology.
Lichen Planus
This disease is often found on the genital region. It presents as violaceous papules and plaques with an overlying white lacy network covering individual lesions. Look in the mouth for lacy patterning on the buccal mucosae (Wickham’s striae). Examine the rest of the body for itchy papules of LP. If vulval LP is suspected please refer for diagnosis. Treatment as for Lichen sclerosus.
There is a combined vulval clinic in Cheltenham General Hospital.