Diseases of the Vulva

Vulvar symptoms are a common reason for a gynecologic visit. A variety of conditions impact the vulva, including dermatologic conditions, hormonal changes, vulvar pain, and sexually transmitted or other infections. History and physical exam, focused on the symptoms and the vulvovaginal area, are crucial to identifying the etiology of the symptoms. A full evaluation may include vulvar biopsies and testing for infections. The treatment of the symptoms depends on the etiology; therefore, an accurate and thorough determination of the cause of the patient’s symptoms is of primary importance. Treatment can include antibiotics, antifungals, steroids, antidepressants, hormones, and pelvic floor physical therapy. In this chapter, we summarize common conditions affecting the vulvar, their evaluation, and their treatment. This review contains 7 figures, 10 tables, and 40 references. Key Words: Bartholin gland, candidiasis, dermatitis, eczema, hidradenitis suppurativa, lichen planus, lichen sclerosus, sexually transmitted infections, vulva, vulvodynia, vulvovaginal atrophy