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.
Sign Up for Free e-newsletters
- Leukemia Risk in Children, Maternal Use of Hormonal Contraception Linked in Population Study
- CheckMate 067 Gives Nivolumab Alone, With Ipilimumab the Nod in Advanced Melanoma
- New Method Estimates Risk for Breast Cancer Recurrence
- Molecular Features May Predict Response in Primary Pancreatic Cancer
- Chemoimmunotherapy prolongs PFS in metastatic triple-negative breast cancer
- Navigating Prostate Cancer: A Patient's Experience From Diagnosis to Survivor
- Cell Phones and Cancer Risk (Fact Sheet)
- How Likely Are Oncologists to Refer for Palliative Care? Depends on Their Age
- Use of Corticosteroids With PD-1 or PD-L1 Inhibitors Associated With Poorer Outcomes in NSCLC
- Seeking an Explanation for the Lack of Research Focused in Pediatric Oncology Therapeutics
- Hodgkin Lymphoma Survivorship Marked by Periods of Actionable Distress
- Open Hysterectomy Survival Rates Edge Minimally Invasive Procedures for Cervical Cancer
- The Efficacy and Safety of Apatinib for Refractory Malignancies: A Review and Meta-analysis
- Study Reveals Relationship of Sleep Duration, Diabetes Risk in Cancer Survivors
- Medication, Vaccination Uptake Improved by Involving Pharmacists in Elder Cancer Care
Regimen and Drug Listings
GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION
|Head and Neck Cancer||Regimens||Drugs|