Current vulvar diagnostic methods, with special reference to vulvar cytology

The established noninvasive procedures for early detection of vulvar cancer failed in the past, probably because they were based on indirect criteria for malignancy. Exfoliative cytology, however, is the only method that is able to identify specific morphologic features although completely different from the well-known features of cervical cytology. A smear should be taken, therefore, from every vulvar lesion. Using all the relevant diagnostic methods, including punch biopsy, should lead to an improvement in early vulvar cancer detection.