Do not be afraid to see a doctor if you experience any of these symptoms. Dr Namuduri Rama Padmavathi, staff physician at KK Gynaecological Cancer Centre, talks about the different types of vulvar skin conditions and their signs.
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"Most women experience discomfort down there at some point or another in their lives, so these problems are nothing to feel embarrassed about," says Dr Namuduri Rama Padmavathi, Staff Physician,
KK Gynaecological Cancer Centre,
KK Women's and Children's Hospital, a member of the
SingHealth group.
While vulvar dermatoses or vulvar skin conditions generally account for less than 5 per cent of gynaecological conditions, they can have a significant impact on a woman’s quality of life.
Common types of vulvar skin conditions
Below are the different types of vulvar skin conditions and what you need to know about them. As there is substantial overlap in the physical signs of various vulvar dermatoses, women with any vulva problems are advised to consult a medical professional for proper diagnosis and treatment recommendations.
Lichen sclerosis
Lichen sclerosis is associated with a weak or malfunctioning immune system.
Symptoms include:
- Lesions that resemble ivory white papules and plaques
- Areas of thinned out or white thickened skin
- Bruising or bleeding from repeated scratching
- Crinkled skin texture (classic symptom)
If there is scarring and a change in skin colour or structure, seek medical attention promptly.
Vulvar eczema
Vulvar eczema is inflammation of the skin resulting from an external agent that acts either as an irritant or an allergen to produce a rash. It can be acute, subacute or chronic. Contact dermatitis is the most common type of vulvar eczema.
Symptoms include:
- Redness, swelling and blistering for acute cases
- Redness, scaling, abrasions and a variable degree of thickened leathery skin for chronic cases
Management of vulvar eczema involves good vulva hygiene, avoidance of irritants – such as soaps, condoms and sanitary napkins – and topical steroids.
If the condition fails to respond to initial therapy within a month, seek assistance from a medical professional.
Lichen simplex chronicus
Lichen simplex chronicus is associated with the end stage of the itch-scratch-itch cycle and can be due to several underlying causes.
Symptoms include:
- Thickened leathery skin with increased skin markings
- Crusting
- Abrasions
- Skin pigmentation changes
Managing lichen simplex chronicus involves breaking the itch-scratch-itch cycle, good vulva hygiene, topical steroids, anti-histamine medication and investigation of the primary cause. If the condition fails to respond to initial therapy within a month, seek help from a medical professional.
Intertrigo
Intertrigo, or skinfold dermatitis, is caused by friction and worsened by additional infection from the bacteria or yeast that is normally present on the skin.
Symptoms include:
- Redness
- Pruned skin
- Cracking or splitting of skin
- Secretion of fluid from cracked skin accompanied by considerable odour (less common symptom)
- Darkening of surrounding skin as a post-inflammatory reaction
Intertrigo management includes using mild steroids with a combination of antifungals, and investigation of the primary cause. Consult a medical professional if additional features such as scaling or hardened leathery skin are present, if the condition does not respond to treatment, or if psoriasis is suspected (see below for description).
Lichen planus
The exact cause of lichen planus is unknown.
Symptoms include:
- Erosions with scarring
- Vaginal involvement
- Pain and itch
If vulvar erosions and ulcers are present, seek medical attention promptly.
Psoriasis
The exact cause of psoriasis is unknown.
Symptoms include:
- Papules and plaques with a silvery white scale
- Lesions which may be bright red, often glazed and well-demarcated, involving the natal cleft (or “butt crack”)
Patients with psoriasis should seek prompt dermatological assessment.
Ref: S13
