Vulval dermatoses

Vulval dermatoses are common and can cause significant symptoms. Any generalized skin disorder may affect the anogenital area, but the most common are eczema and psoriasis. Other dermatoses preferentially affect the vulva (e.g. lichen sclerosus, lichen planus). Itching and soreness are the most common symptoms. Many women are not examined and are misdiagnosed with 'thrush'. Self-treatment with topical medications may delay accurate diagnosis and increase the risk of secondary irritant reactions. Knowledge of the appearance of the normal vulva is important to enable recognition of abnormalities. This allows proper diagnosis and appropriate therapy. Infections should be excluded by swabs and possible referral to a GUM department. When the problem is thought to be in the anogenital skin, referral to a dermatologist or a vulval clinic is appropriate.