Diagnosis and management of vulvar skin disorders

Obstetrics and Gynecology

Volumn 111, Issue 5, 2008, Pages 1243-1253

[No Author Info available]

Author keywords

[No Author keywords available]

Indexed keywords

4 AMINOBENZOATE POTASSIUM; AMINOLEVULINIC ACID; AZATHIOPRINE; CLOBETASOL PROPIONATE; CORTICOSTEROID; CYCLOPHOSPHAMIDE; CYCLOSPORIN; ESTROGEN; HYDROXYCHLOROQUINE; HYDROXYCHLOROQUINE SULFATE; LUBRICATING AGENT; MACROLIDE; METHOTREXATE; PIMECROLIMUS; PROGESTERONE; RETINOID; STEROID; TACROLIMUS; TESTOSTERONE; ANDROGEN;

ATROPHY; BLEEDING; CANDIDIASIS; CLINICAL FEATURE; CLINICAL TRIAL; CONTACT DERMATITIS; CONTROLLED CLINICAL TRIAL; CRYOTHERAPY; DISEASE ASSOCIATION; DISEASE COURSE; DISEASE SEVERITY; DRUG DOSE REDUCTION; HISTOPATHOLOGY; HUMAN; LABIAL ADHESION; LICHEN PLANUS; LICHEN SCLEROSUS ET ATROPHICUS; MASTALGIA; PAGET SKIN DISEASE; PAIN; PATHOGENESIS; PERINEUM PAIN; PHOTODYNAMIC THERAPY; PRIORITY JOURNAL; PUNCH BIOPSY; RADIATION INJURY; RANDOMIZED CONTROLLED TRIAL; REVIEW; SECONDARY INFECTION; STRIA; TELANGIECTASIA; TREATMENT INDICATION; TREATMENT OUTCOME; UNSPECIFIED SIDE EFFECT; VAGINA ATROPHY; VAGINAL BURNING SENSATION; VIRILIZATION; VIRUS INFECTION; VULVA DISEASE; VULVA PRURITUS; VULVAR LICHEN SIMPLEX CHRONICUS; VULVODYNIA; VULVOVAGINITIS; WART VIRUS; ADULT; ARTICLE; AUTOIMMUNE DISEASE; COMORBIDITY; DIFFERENTIAL DIAGNOSIS; FEMALE; IMMUNOLOGY; PATHOLOGY; PRACTICE GUIDELINE; PRURITUS; SKIN DISEASE; VULVA;

ADULT; ANDROGENS; ATROPHY; AUTOIMMUNE DISEASES; COMORBIDITY; DIAGNOSIS, DIFFERENTIAL; ESTROGENS; FEMALE; HUMANS; LICHEN PLANUS; LICHEN SCLEROSUS ET ATROPHICUS; PRURITUS; SKIN DISEASES; TESTOSTERONE; VULVA; VULVAR DISEASES;

EID: 42949131137     PISSN: 00297844     EISSN: None     Source Type: Journal    
DOI: 10.1097/AOG.0b013e31817578ba     Document Type: Review

References (90)

1. Hansen A, Carr K, Jensen JT. Characteristics and initial diagnoses in women presenting to a referral center for vulvovaginal disorders in 1996-2000. J Reprod Med 2002;47:854-60. (Level III)
2. Bornstein J, Pascal B, Abramovici H. The common problem of vulvar pruritus. Obstet Gynecol Surv 1993;48:111-8. (Level III)
3. Kehoe S, Luesley D. Pathology and management of vulval pain and pruritus. Curr Opin Obstet Gynecol 1995;7:16-9. (Level III)
4. Moyal-Barracco M, Lynch PJ. 2003 ISSVD terminology and classification of vulvodynia: a historical perspective. J Reprod Med 2004;49:772-7. (Level III)
5. Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. Centers for Disease Control and Prevention [published erratum appears in MMWR Recomm Rep 2006;55:997]. MMWR Recomm Rep 2006;55(RR-11):1-94. (Level III)
6. Crone AM, Stewart EJ, Wojnarowska F, Powell SM. Aetiological factors in vulvar dermatitis. J Eur Acad Dermatol Venereol 2000;14:181-6. (Level III)
7. Marren P, Wojnarowska F, Powell S. Allergic contact dermatitis and vulvar dermatoses. Br J Dermatol 1992;126:52-6. (Level III)
8. Margesson LJ. Contact dermatitis of the vulva. Dermatol Ther 2004;17:20-7. (Level III)
9. Virgili A, Bacilieri S, Corazza M. Managing vulvar lichen simplex chronicus. J Reprod Med 2001;46:343-6. (Level III)
10. Thomas RH, Ridley CM, McGibbon DH, Black MM. Anogenital lichen sclerosus in women. J R Soc Med 1996;89:694-8. (Level III)
11. Pokorny SF. Prepubertal vulvovaginopathies. Obstet Gynecol Clin North Am 1992;19:39-58. (Level III)
12. Smith YR, Haefner HK. Vulvar lichen sclerosus: pathophysiology and treatment. Am J Clin Dermatol 2004;5:105-25. (Level III)
13. Val I, Almeida G. An overview of lichen sclerosus. Clin Obstet Gynecol 2005;48:808-17. (Level III)
14. Funaro D. Lichen sclerosus: a review and practical approach. Dermatol Ther 2004;17:28-37. (Level III)
15. O'Keefe RJ, Scurry JP, Dennerstein G, Sfameni S, Brenan J. Audit of 114 non-neoplastic vulvar biopsies. Br J Obstet Gynaecol 1995;102:780-6. (Level I)
16. Neill SM, Tatnall FM, Cox NH. Guidelines for the management of lichen sclerosus. British Association of Dermatologists. Br J Dermatol 2002;147:640-9. (Level III)
17. Eisen D. The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. J Am Acad Dermatol 2002;46:207-14. (Level III)
18. Eisen D. The evaluation of cutaneous, genital, scalp, nail, esophageal, and ocular involvement in patients with oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:431-6. (Level III)
19. Rogers RS 3rd, Eisen D. Erosive oral lichen planus with genital lesions: the vulvovaginal-gingival syndrome and the peno-gingival syndrome. Dermatol Clin 2003;21:91-8, vi-vii. (Level III)
20. Moyal-Barracco M, Edwards L. Diagnosis and therapy of anogenital lichen planus. Dermatol Ther 2004;17:38-46. (Level III)
21. Kennedy CM, Galask RP. Erosive vulvar lichen planus: retrospective review of characteristics and outcomes in 113 patients seen in a vulvar specialty clinic. J Reprod Med 2007;52:43-7. (Level III)
22. Ramer MA, Altchek A, Deligdisch L, Phelps R, Montazem A, Buonocore PM. Lichen planus and the vulvovaginal-gingival syndrome. J Periodontol 2003;74:1385-93. (Level III)
23. Greendale GA, Judd HL. The menopause: health implications and clinical management. J Am Geriatr Soc 1993;41:426-36. (Level III)
24. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD001500. DOI: 10.1002/14651858.CD001500.pub2. (Level III)
25. Johnston SL, Farrell SA, Bouchard C, Farrell SA, Beckerson LA, Comeau M, et al. The detection and management of vaginal atrophy. SOGC Joint Committee-Clinical Practice Gynaecology and Urogynaecology. J Obstet Gynaecol Can 2004;26:503-15. (Level III)
26. Smith RN, Studd JW. Recent advances in hormone replacement therapy. Br J Hosp Med 1993;49:799-808. (Level III)
27. Bohl TG. Overview of vulvar pruritus through the life cycle. Clin Obstet Gynecol 2005;48:786-807. (Level III)
28. Hillier SL, Lau RJ. Vaginal microflora in postmenopausal women who have not received estrogen replacement therapy. Clin Infect Dis 1997;25(suppl 2):S123-6. (Level III)
29. Farage M, Maibach H. Lifetime changes in the vulva and vagina. Arch Gynecol Obstet 2006;273:195-202. (Level III)
30. Ballagh SA. Vaginal hormone therapy for urogenital and menopausal symptoms. Semin Reprod Med 2005;23:126-40. (Level III)
31. Fidel PL Jr, Vazquez JA, Sobel JD. Candida glabrata: review of epidemiology, pathogenesis, and clinical disease with comparison to C. albicans. Clin Microbiol Rev 1999;12:80-96. (Level III)
32. Sobel JD, Wiesenfeld HC, Martens M, Danna P, Hooton TM, Rompalo A, et al. Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis. N Engl J Med 2004;351:876-83. (Level I)
33. Vulvodynia. ACOG Committee Opinion No. 345. American College of Obstetricians and Gynecologists. Obstet Gynecol 2006;108:1049-52. (Level III)
34. Bachmann GA, Rosen R, Pinn VW, Utian WH, Ayers C, Basson R, et al. Vulvodynia: a state-of-the-art consensus on definitions, diagnosis and management. J Reprod Med 2006;51:447-56. (Level III)
35. Parker LP, Parker JR, Bodurka-Bevers D, Deavers M, Bevers MW, Shen-Gunther J, et al. Paget's disease of the vulva: pathology, pattern of involvement, and prognosis. Gynecol Oncol 2000;77:183-9. (Level II-3)
36. Finan MA, Barre G. Bartholin's gland carcinoma, malignant melanoma and other rare tumours of the vulva. Best Pract Res Clin Obstet Gynaecol 2003;17:609-33. (Level III)
37. Jones RW, Joura EA. Analyzing prior clinical events at presentation in 102 women with vulvar carcinoma. Evidence of diagnostic delays. J Reprod Med 1999;44:766-8. (Level II-2)
38. Kundu S, Achar S. Principles of office anesthesia: part II. Topical anesthesia. Am Fam Physician 2002;66:99-102. (Level III)
39. Eidelman A, Weiss JM, Lau J, Carr DB. Topical anesthetics for dermal instrumentation: a systematic review of randomized, controlled trials. Ann Emerg Med 2005;46:343-51. (Level III)
40. Achar S, Kundu S. Principles of office anesthesia: part I. Infiltrative anesthesia. Am Fam Physician 2002;66:91-4. (Level III)
41. Zuber TJ. Punch biopsy of the skin. Am Fam Physician 2002;65:1155-8, 1161-2, 1164, 1167-8. (Level III)
42. Mirowski G, Edwards L. Diagnostic and therapeutic procedures. In: Edwards L, editor. Genital dermatology atlas. Philadelphia (PA): Lippincott Williams & Wilkins; 2004. p. 9-17. (Level III)
43. Alguire PC, Mathes BM. Skin biopsy techniques for the internist. J Gen Intern Med 1998;13:46-54. (Level III)
44. Tebruegge M, Misra I, Nerminathan V. Is the topical application of oestrogen cream an effective intervention in girls suffering from labial adhesions? Arch Dis Child 2007;92:268-71. (Level III)
45. Bacon JL. Prepubertal labial adhesions: evaluation of a referral population. Am J Obstet Gynecol 2002;187:327-31; discussion 332. (Level II-3)
46. Myers JB, Sorensen CM, Wisner BP, Furness PD 3rd, Passamaneck M, Koyle MA. Betamethasone cream for the treatment of pre-pubertal labial adhesions. J Pediatr Adolesc Gynecol 2006;19:407-11. (Level II-3)
47. Rioux JE, Devlin C, Gelfand MM, Steinberg WM, Hepburn DS. 17beta-estradiol vaginal tablet versus conjugated equine estrogen vaginal cream to relieve menopausal atrophic vaginitis. Menopause 2000;7:156-61. (Level I)
48. Ayton RA, Darling GM, Murkies AL, Farrell EA, Weisberg E, Selinus I, et al. A comparative study of safety and efficacy of continuous low dose oestradiol released from a vaginal ring compared with conjugated equine oestrogen vaginal cream in the treatment of postmenopausal urogenital atrophy. Br J Obstet Gynaecol 1996;103:351-8. (Level I)
49. Nachtigall LE. Comparative study: Replens versus local estrogen in menopausal women. Fertil Steril 1994;61:178-80. (Level III)
50. Cardozo L, Bachmann G, McClish D, Fonda D, Birgerson L. Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol 1998;92:722-7. (Level III)
51. Foster DC. Vulvar disease. Obstet Gynecol 2002;100:145-63. (Level III)
52. Nappi RE, Ferdeghini F, Sampaolo P, Vaccaro P, De Leonardis C, Albani F, et al. Clitoral circulation in postmenopausal women with sexual dysfunction: a pilot randomized study with hormone therapy. Maturitas 2006;55:288-95. (Level II-1)
53. Girton S, Kennedy CM, Galask RP. Characteristics and outcomes of 16 patients with symptomatic labial adhesion. Internet J Gynecol Obstet 2007;7(1). Available at: http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijgo/ vol7n1/labial.xml. Retrieved January 10, 2008. (Level III)
54. Schober J, Dulabon L, Martin-Alguacil N, Kow LM, Pfaff D. Significance of topical estrogens to labial fusion and vaginal introital integrity. J Pediatr Adolesc Gynecol 2006;19:337-9. (Level III)
55. Grigsby PW, Russell A, Bruner D, Eifel P, Koh WJ, Spanos W, et al. Late injury of cancer therapy on the female reproductive tract. Int J Radiat Oncol Biol Phys 1995;31:1281-99. (Level III)
56. Ou KY, Chen YC, Hsu SC, Tsai EM. Topical vaginal oestrogen cream used for treatment of burn injury of vaginal mucosa after misapplication of 100% acetic acid in a perimenopausal woman: a case report. Aust N Z J Obstet Gynaecol 2007;47:345-6. (Level III).
57. Sideri M, Origoni M, Spinaci L, Ferrari A. Topical testosterone in the treatment of vulvar lichen sclerosus. Int J Gynaecol Obstet 1994;46:53-6. (Level III)
58. Cattaneo A, Carli P, De Marco A, Sonni L, Bracco G, De Magnis A, et al. Testosterone maintenance therapy. Effects on vulvar lichen sclerosus treated with clobetasol propionate. J Reprod Med 1996;41:99-102. (Level I)
59. Bornstein J, Heifetz S, Kellner Y, Stolar Z, Abramovici H. Clobetasol dipropionate 0.05% versus testosterone propionate 2% topical application for severe vulvar lichen sclerosus. Am J Obstet Gynecol 1998;178:80-4. (Level II-3)
60. Leiblum S, Bachmann G, Kemmann E, Colburn D, Swartzman L. Vaginal atrophy in the postmenopausal woman. The importance of sexual activity and hormones. JAMA 1983;249:2195-8. (Level II-3)
61. Laan E, van Lunsen RH. Hormones and sexuality in postmenopausal women: a psychophysiological study. J Psychosom Obstet Gynaecol 1997;18:126-33. (Level II-3)
62. Bygdeman M, Swahn ML. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas 1996;23:259-63. (Level I)
63. Bracco GL, Carli P, Sonni L, Maestrini G, De Marco A, Taddei GL, et al. Clinical and histologic effects of topical treatments of vulval lichen sclerosus. A critical evaluation. J Reprod Med 1993;38:37-40. (Level II-3)
64. Lorenz B, Kaufman RH, Kutzner SK. Lichen sclerosus. Therapy with clobetasol propionate. J Reprod Med 1998;43:790-4. (Level III)
65. Cooper SM, Gao XH, Powell JJ, Wojnarowska F. Does treatment of vulvar lichen sclerosus influence its prognosis? Arch Dermatol 2004;140:702-6. (Level II-2)
66. Lagos BR, Maibach HI. Frequency of application of topical corticosteroids: an overview. Br J Dermatol 1998;139:763-6. (Level III)
67. Dalziel KL, Wojnarowska F. Long-term control of vulval lichen sclerosus after treatment with a potent topical steroid cream. J Reprod Med 1993;38:25-7. (Level III)
68. Renaud-Vilmer C, Cavelier-Balloy B, Porcher R, Dubertret L. Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. Arch Dermatol 2004;140:709-12. (Level II-2)
69. Baggish MS, Ventolini G. Lichen sclerosus: subdermal steroid injection therapy. A large, long-term follow-up study. J Gynecol Surg 2006,22:137-41. (Level III)
70. Bousema MT, Romppanen U, Geiger JM, Baudin M, Vaha-Eskeli K, Vartiainen J, et al. Acitretin in the treatment of severe lichen sclerosus et atrophicus of the vulva: a double-blind, placebo-controlled study. J Am Acad Dermatol 1994;30:225-31. (Level I)
71. Virgili A, Corazza M, Bianchi A, Mollica G, Califano A. Open study of topical 0.025% tretinoin in the treatment of vulvar lichen sclerosus. One year of therapy. J Reprod Med 1995;40:614-8. (Level III)
72. Penneys NS. Treatment of lichen sclerosus with potassium para-aminobenzoate. J Am Acad Dermatol 1984;10:1039-42. (Level III)
73. August PJ, Milward TM. Cryosurgery in the treatment of lichen sclerosus et atrophicus of the vulva. Br J Dermatol 1980;103:667-70. (Level III)
74. Hillemanns P, Untch M, Prove F, Baumgartner R, Hillemanns M, Korell M. Photodynamic therapy of vulvar lichen sclerosus with 5-aminolevulinic acid. Obstet Gynecol 1999;93:71-4. (Level III)
75. Carli P, Cattaneo A, Taddei G, Giannotti B. Topical cyclosporine in the treatment of vulvar lichen sclerosus: clinical, histologic, and immunohistochemical findings. Arch Dermatol 1992;128:1548-9. (Level III)
76. Joura EA, Zeisler H, Bancher-Todesca D, Sator MO, Schneider B, Gitsch G. Short-term effects of topical testosterone in vulvar lichen sclerosus. Obstet Gynecol 1997;89:297-9. (Level II-3)
77. Leone M, Gerbaldo D, Caldana A, Leone MM, Capitanio GL. Progesterone topically administered influences epidermal growth factor immunoreactivity in vulvar tissue from patients with lichen sclerosus. Cervix Low Female Genital Tract 1993;11:25-7. (Level III)
78. Bohm M, Frieling U, Luger TA, Bonsmann G. Successful treatment of anogenital lichen sclerosus with topical tacrolimus. Arch Dermatol 2003;139:922-4. (Level III)
79. Goldstein AT, Marinoff SC, Christopher K. Pimecrolimus for the treatment of vulvar lichen sclerosus: a report of 4 cases. J Reprod Med 2004;49:778-80. (Level III)
80. Hengge UR, Krause W, Hofmann H, Stadler R, Gross G, Meurer M, et al. Multicentre, phase II trial on the safety and efficacy of topical tacrolimus ointment for the treatment of lichen sclerosus. Br J Dermatol 2006;155:1021-8. (Level II-3)
81. Rouzier R, Haddad B, Deyrolle C, Pelisse M, Moyal-Barracco M, Paniel BJ. Perineoplasty for the treatment of introital stenosis related to vulvar lichen sclerosus. Am J Obstet Gynecol 2002;186:49-52. (Level III)
82. Anderson M, Kutzner S, Kaufman RH. Treatment of vulvovaginal lichen planus with vaginal hydrocortisone suppositories. Obstet Gynecol 2002;100:359-62. (Level III)
83. Byrd JA, Davis MD, Rogers RS 3rd. Recalcitrant symptomatic vulvar lichen planus: response to topical tacrolimus. Arch Dermatol 2004;140:715-20. (Level III)
84. Jensen JT, Bird M, Leclair CM. Patient satisfaction after the treatment of vulvovaginal erosive lichen planus with topical clobetasol and tacrolimus: a survey study. Am J Obstet Gynecol 2004;190:1759-63; discussion 1763-5. (Level III)
85. Cooper SM, Wojnarowska F. Influence of treatment of erosive lichen planus of the vulva on its prognosis. Arch Dermatol 2006;142:289-94. (Level II-2)
86. Lewis FM. Vulval lichen planus. Br J Dermatol 1998;138:569-75. (Level III)
87. Gunthert AR, Hinney B, Nesselhut K, Hanf V, Emons G. Vulvitis granulomatosa and unilateral hypertrophy of the vulva related to Crohn's disease: a case report. Am J Obstet Gynecol 2004;191:1719-20. (Level III)
88. Setterfield JF, Neill S, Shirlaw PJ, Theron J, Vaughan R, Escudier M, et al. The vulvovaginal gingival syndrome: a severe subgroup of lichen planus with characteristic clinical features and a novel association with the class II HLA DQB1*0201 allele. J Am Acad Dermatol 2006;55:98-113. (Level II-2)
89. Lynch PJ, Edwards L. White patches and plaques. In: Genital dermatology. New York (NY): Churchill Livingstone; 1994. p. 149-62. (Level III)
90. Lloyd J, Flanagan AM. Mammary and extramammary Paget's disease. J Clin Pathol 2000;53:742-9. (Level III)