Women with vulvar skin conditions should seek medical help to rule out life-threatening illnesses like cancer. Dr Namuduri Rama Padmavathi, staff physician at KK Gynaecological Cancer Centre, shares.
Often, out of embarrassment, women avoid seeking medical help and instead attempt to self-diagnose and self-treat with over-the-counter medications.
But problems affecting your private area are nothing to be embarrassed about. In fact, if you have vulvar problems, it is important to consult a medical professional in order to rule out potentially life-threatening illnesses like cancer and get proper advice on treatment.
What you need to know about vulvar dermatoses
Vulvar dermatoses refer to skin conditions affecting the vulva or the outer part of the female genitals. These can include a spectrum of dermatological conditions, such as lichen sclerosus, lichen simplex chronicus and lichen planus.
Signs and symptoms of vulvar dermatoses
Common signs and symptoms of vulvar dermatoses include:
- Itching
- White discoloration
- Swelling
- Pain (e.g. during intercourse)
- Redness
- Exfoliation of skin
- Raised lesions over skin
- Oozing
- Constipation
- Burning sensation (e.g. during urination)
- Ulceration, erosion and thickening of skin
Diagnosis
Diagnosis of vulvar skin conditions is often challenging due to several factors. Vulvar anatomy has a range of normal variants – that is to say, a symptom that is unusual or malignant for others may actually be benign for you.
In addition, there is considerable overlap in the physical signs of the various conditions. Manifestations of diseases on vulvar skin are different from other areas of the body, so this can lead to an initial misdiagnosis.
Conditions which are prone to being misdiagnosed include vulvar intraepithelial neoplasia and Paget’s disease of the vulva. These are commonly mistaken for vulvar eczema due to the similarities of their symptoms – itching and redness of skin.
Certain rare cancers of the vulva, such as basal cell cancer of the skin, may also present as skin growths or lesions characteristic of eczema, and thus can be mistaken for simple moles or warts.
These challenges can lead patients to wait many years before seeking treatment, which can negatively impact their clinical outcomes. Thus, if your vulvar skin condition is not responding to initial therapy, you should seek professional assessment so that potentially serious underlying conditions can be ruled out.
Managing vulvar dermatoses at KKH
Vulvar health is a unique area in which both gynaecology and dermatology specialties play equally vital roles. Should a patient complain of vulvar itching or burning, a gynaecologist may not immediately suspect a dermatological cause. Similarly, the comprehensive gynecological examination, which includes the vulva, vagina and cervix, may not be complete in a dermatological setting.
The Vulvar Clinic at
KK Women’s & Children’s Hospital (KKH), a member of the
SingHealth group, incorporates both gynaecological and dermatological expertise to provide comprehensive management for vulvar conditions. It also plays an important role in improving public awareness and understanding of vulvar diseases.
Over a period of 34 months, from July 2010 to April 2013, the Vulvar Clinic attended to 670 new patients with vulvar problems as their primary complaint. A comprehensive history was taken, followed by a detailed dermatological and gynaecological examination, which included colposcopy of the entire lower genital tract where necessary.
Of these patients, about 54 per cent presented with vulvar dermatoses, including lichen sclerosus (18.5%), vulvar eczema (16.4%), lichen simplex chronicus (12.5%), intertrigo (4.9%), lichen planus (0.8%) and psoriasis (0.7%).
Read on to learn more about the different type of vulvar skin conditions.
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