Vulvar ulcers and erosions--a dermatologist's viewpoint

Vulvar ulceration can occur as the primary or secondary event in a large variety of conditions. These include infections, autoimmune and/or inflammatory diseases and dermatoses, neoplasias, and conditions with an unknown etiology. A thorough medical history and careful patient examination remain the linchpin of management. Specific microbiological, histological, immunological, and other investigations are often necessary to establish or confirm a diagnosis, but the relevant importance of these will vary in the individual patient. The specific management of each patient will also vary accordingly. Other important factors which will influence the frequency with which any physician will make one of the specific diagnoses include practice location, referral mechanisms, and population demographics. This chapter is written with the generalist dermatologist in mind. Whilst dermatoses are given prime attention, important infections and other conditions are also dealt with. The ultimate aim of the present paper is to provide the generalist dermatologist with a useful tool for the diagnosis and management of a patient that present's with a vulvar ulcer(s).