Vulva Flashcards
Vulva erythematous/rash DDx
- Dermatitis
- Chronic vulvovaginal candidiasis
- Psoriasis
- Tinea cruis
Dermatitis info+ types
- Poorly defined erythema
- Atopic ➤ personal/family of eczema, hay fever, asthma ➤ impaired epidermal barrier
- Irritant contact ➤ soap, water, detergents, fragrance, lub, sanitary pads, condoms, sauna
- Allergic contact
- Oestrogen hypersensitivity
Dermatitis - Tx
Corticosteroids
Chronic vulvovaginal candidiasis - S&S
itch, P, discomfort, burning, soreness
Chronic vulvovaginal candidiasis - Tx
Hydrocortisone (itch) + topical & oral anti fungal
Chronic vulvovaginal candidiasis - population affected
20-40 yo female immunocompetent
Vulva Psoriasis - info
- Defined border
- Involvement of folds
- No psoriatic scales
Tinea Cruis - info
- Central clear area
- Peripheral scalling
- Follicular papules
➤ Fungal infection
Vulva pallor - Ddx
- Litchen Sclerosus
- Litchen simplex
- Vitiligo
- Vulvar intraepithelial neoplasia (VIN)
Litchen sclerosis - Infos
- Porcelain white papules
- S&S: asymptomatic, itch
- Genetic / AI link
- Atrophic / hyperkeratotic
- Late stage: change in architecture
- Risk of malignancy
- Can result in labial lesion + intraoital stenosis
- Tx: corticosteroid
Vitiligo - Infos
- Asymptomatic
- Depigmentation
VIN - Infos
- Vulvar intraepithelial neoplasia
- In situ carcinoma
- Younger women ➤ associated with HPV
- Associated with lichen sclerosis
Vulvar carcinoma - S&S
Itch Lump Bleeding P Skin changes
Who is affected by Vulvar carcinoma?
70+
What is Vulvar carcinoma associated with?
Smoking HPV Immunodeficiency VIN Lichen sclerosus
Vulvar carcinoma - Type of CA
90% squamous cell carcinoma
Vulvar carcinoma - Tx
Surgery
? chemo
Vulvar carcinoma - morbidity
High
Vulva erosions - infos
- P due to breach in epithelium
- Associated with: herpes simplex, ulceration, viral infections, idiopathic
- Tx: corticosteroid
- Ex: kitchen planus
Vulva lesions - infos
- Linked with gonorrhoea, chlamydia, E. coli
- Puberty - menopause ++
- Tx: leave alone if asymptomatic, warm bath, compress, surgery, aspiration
- Ex: Bartholin cyst = abscess in gland just outside vagina
Extra-mammary Paget’s disease - S&S
Eczematous itchy plaque
Extra-mammary Paget’s disease - Who?
60+, postmenopausal
Extra-mammary Paget’s disease - Tx
Corticosteroid
If fails ➤ surgery, chemo, radio
Investigate local + distant adenocarcinoma
