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The Human Vulvar Microbiome: A Systematic Review.

Lisa Pagan^1,2, Roos A M Ederveen^3,4, Bertine W Huisman^1,2

¹Centre for Human Drug Research, 2333 CL Leiden, The Netherlands.

|December 24, 2021

Summary

The vulvar microbiome, the collection of microbes on vulvar skin, shows similarities to the vaginal environment but with higher diversity. Research is limited but suggests potential links to vulvar (pre)malignant diseases.

Keywords:

cancer development drug development microbial targets vaginal microbiome vulvar microbiome

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Area of Science:

Microbiology
Oncology
Dermatology

Background:

The connection between the microbiome and cancer is an emerging research area.
Knowledge regarding the vulvar skin microbiome in (pre)malignant conditions is scarce.

Purpose of the Study:

To systematically review existing literature on the microbiome composition of healthy vulvar skin.
To investigate the microbiome in (pre)malignant vulvar diseases.

Main Methods:

Systematic review adhering to PRISMA guidelines.
Comprehensive electronic literature search updated to September 2021.
Inclusion of studies using culture-independent microbiome profiling of the vulvar region.

Main Results:

Ten articles met the inclusion criteria.
The vulvar microbiome includes genera such as *Lactobacillus*, *Corynebacterium*, *Staphylococcus*, and *Prevotella*.
Vulvar microbiome composition shares similarities with the vaginal milieu but exhibits higher diversity, including cutaneous and fecal commensals.

Conclusions:

This is the first systematic review on the microbiome in relation to vulvar (pre)malignant disease.
Current data is limited, with low evidence levels due to study size, population diversity, and methodological constraints.
The vulvar microbiome presents a promising avenue for investigating disease etiology and therapeutic targets.