Obstetrics and Gynecology
Vulvovaginal Disorders: Introduction to Noninfectious Vulvovaginal Diseases
1. What every clinician should know
Pruritus and pain are two of the most common presenting symptoms in women with vulvovaginal disorders. Pruritus and irritation can occur in the presence of obvious dermatologic changes or in conditions with few visible skin changes. Vulvovaginal pain or discomfort can arise in the number of settings, some with obvious clinical signs (e.g., infections such as candidaisis or bacterial vaginosis, inflammation such as lichen planus, neoplasia such as VIN or squamous cell cancer of the vulva, or neurologic disorders such as postherpetic neuralgia) and others in the absence of visible findings (e.g., vulvodynia)
Risk factors depend on the condition diagnosed. Women with lichen simplex chronicus (also termed squamous cell hyperplasia) are more likely to report a history of atopic disease. Women at risk for the development of well-differentiated or simplex vulvar intraepithelial neoplasia include those with a history of lichen sclerosus, while those with poorly-differentiated VIN share risk factors for acquisition of HPV infection (e.g., sexual behaviors such as number of lifetime partners as well as smoking). Immunosuppression also increases risk of certain vulvovaginal disorders including candidiasis and lower anogenital tract intraepithelial neoplasia.
Vulvar symptoms are common, often chronic and can interfere significantly with women's sexual function and sense of well-being. Remaining aware of the differences in epithelial and glandular structure, hormonal responsiveness, neural distribution and immune responses that results from the differences in origin is crucial in assessing and successfully managing vulvar symptoms. The importance of a thorough patient history and careful physical examination are critical in the assessment of vulvar disorders and help to direct the appropriate use of additional testing and choice of management options.
Copyright © 2017, 2014 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
- Blood Test Predicts Stem Cell Transplant Success in Myelodysplastic Syndrome
- Immunotherapy and the Future of Prostate Cancer Treatment
- Trends in Behaviors, Medical Practice Indicate Mortality From Melanoma Will Decline
- Pembrolizumab Active Against Rare Melanoma, Extends Survival in Bladder Cancer
- Elderly with NSCLC Can Tolerate Aggressive Radiation Therapy Treatments
- Survivors Reporting Chronic Neuropathic Pain Struggle to Retain Jobs
- Timing of Chemotherapy Infusion Affects Inflammatory Response to Chemotherapy
- Postoperative Gemcitabine Plus Capecitabine: A New Standard of Care for Pancreatic Cancer
- Blood-Forming Stem Cell Transplants (Fact Sheet)
- Nut Consumption Inversely Associated With Lung Cancer Risk
- Pediatric Patients, Parents Overreport Adherence to ALL Medication Regimen
- E-cigarettes and Replacement Nicotine Therapy Safer Than Tobacco Use
- National Health Care Spending Expected to Grow Five Percent Annually
- Patients With Urologic Cancer Need Psycho-oncologic Support to Manage High Stress
- 1 Year of Adjuvant Trastuzumab Improves Long-Term DFS in Early Breast Cancer
Sign Up for Free e-newsletters
Regimen and Drug Listings
GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION
|Head and Neck Cancer||Regimens||Drugs|