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The chronically symptomatic vulva: aetiology and management
G Fischer1, B Spurrett, A Fischer
1Royal Alexandra Hospital for Children, Sydney, Australia.
British Journal of Obstetrics and Gynaecology
|October 1, 1995
Summary
Most chronic vulval symptoms stem from treatable dermatitis, not human papilloma virus (HPV). Dermatological treatments, particularly topical corticosteroids, are effective for the majority of patients presenting with vulval conditions.
Area of Science:
- Dermatology
- Gynaecology
- Pathology
Background:
- Chronic vulval symptoms present a diagnostic challenge.
- Patients often seek care from both gynaecologists and dermatologists.
- Differentiating dermatological from gynaecological causes is crucial for effective management.
Purpose of the Study:
- To identify the causes and optimal management of chronic vulval symptoms.
- To compare diagnostic findings between gynaecologist and dermatologist referrals.
- To assess the role of human papilloma virus (HPV) in chronic vulval conditions.
Main Methods:
- Prospective study of 144 patients referred to gynaecology or dermatology.
- Diagnosis based on clinical history, vulvoscopy, biopsy, and bacteriology.
- Biopsies reviewed by experienced histopathologists.
Main Results:
- Dermatitis was the most common cause (64%), often responding to topical corticosteroids.
- Human papilloma virus (HPV) was found in 23% of patients, with many also having dermatitis.
- Lichen sclerosus and other dermatoses were also identified, predominantly responsive to corticosteroids.
Conclusions:
- The majority of chronic vulval symptoms are dermatological and respond to simple treatments.
- Focusing on human papilloma virus (HPV) is often unnecessary for symptom resolution.
- Gynaecologists and histopathologists may overlook common dermatological conditions.
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