Vulvar dystrophies and intraepithelial neoplasias

The warmth and moisture present in all intertriginous locations distorts the lesional morphology of many vulvar diseases. Specifically, wetness leads to the development of a nondistinctive, white hyperhydration of any scale that is present, and this, in turn, masks the characteristic features of the underlying pathology. These same factors increase the severity of pruritus and thus lead to scratching and eczematization of what, in other locations, would be more readily recognizable disease. Those diagnostic hallmarks that do remain are emphasized in this article, and those aspects of therapy that are unique to a vulvar location are discussed.