Update vulval dermatology – diagnostics and therapy

Abstract

The vulva is a periorificial skin area and as such represents a transitional zone with unique functional and physiological characteristics. Knowledge of its anatomy is limited among both the general population and healthcare professionals, and unrealistic expectations of normal proportions are common. Ignorance of anatomical variations can cause unnecessary anxiety. In Germany, specialists in gynecology and obstetrics most commonly treat neoplastic vulvar dermatoses, while chronic inflammatory dermatoses commonly affecting the female genitalia (such as psoriasis, atopic dermatitis, hidradenitis suppurativa, and vitiligo) are typically treated by dermatologists. Both specialties treat infectious vulvar dermatoses and sexually transmitted infections. Certain dermatoses, such as lichen sclerosus, lichen planus, and lichen simplex chronicus, tend to affect the vulva preferentially; however, terminology can be confusing. Therefore, this article provides basic information on vulvar anatomy and physiology and summarizes recommendations for the diagnosis and management of the most common vulvar dermatoses, with a special focus on chronic inflammatory dermatoses, to provide a useful guide for all involved specialists in daily practice. Interdisciplinary collaboration and the establishment of dedicated consultation hours may help to improve the clinical care of vulvar dermatoses.