vulvar dystrophy

Vulvar Dystrophy: A Condition Affecting the Vulva

Vulvar dystrophy refers to a medical condition that changes the skin of the vulva, which is the external genital area in women. The vulva includes the folds of skin around the opening of the vagina and urethra.

• Types of Vulvar Dystrophy: There are several types of vulvar dystrophy, including:
  • Squamous hyperplasia: associated with itchy, reddish skin and raised white areas
  • Lichen sclerosus: characterized by thinning or thickening of the skin and dryness
  • Hypertrophic vulvar dystrophy: where the skin of the vulva grows too thick
  • Mixed dystrophy: a combination of both hypertrophic and lichen sclerosus types
• Symptoms: Vulvar dystrophy can cause various symptoms, including:
  • Itching or burning on the vulva
  • Visible skin color changes to white, grey

Common Signs and Symptoms of Vulvar Dystrophy

Vulvar dystrophy, also known as vulvar dermatosis, is a general term for skin diseases that cause itching in the genital region. The symptoms can vary depending on the specific condition, but here are some common signs and symptoms:

• Itching or burning sensation: A persistent feeling of itchiness or burning on the vulva, which can be uncomfortable and disrupt daily activities.
• Visible skin color changes: Discoloration of the vulvar skin, ranging from white to grey, pink, reddish, or dark brown.
• Painful sores: Development of painful sores around the vulva, which can be a symptom of conditions like lichen sclerosus.
• Redness and inflammation: Redness and inflammation of the vulvar skin, which can be accompanied by pain and discomfort.
• Vulvar bleeding: Bleeding in the genital area that is not related to menstruation.
• Vaginal discharge with unpleasant odor: An abnormal vaginal discharge with an unpleasant smell.

These symptoms can be caused by various conditions, including lichen sclerosus, vulvodynia, and others. If you are experiencing any of these symptoms, it's essential to consult a healthcare professional for proper diagnosis and treatment.

References:

• [1] Vulvar itchiness · Vulvar pain · Vulvar bleeding · Vaginal discharge with an unpleasant odor · Whitish skin discoloration in the vulvar region · A sore on the vulva ... (Search Result 6)
• [7] Vulvar dystrophies are the general name of skin diseases with itching in the genital region. All skin diseases can be seen on the skin in the external genital ... (Search Result 7)
• [8] Symptoms include severe itching and pain, white patches of skin on the vulva, areas of bruising, and thin, dry, crinkled skin that splits easily, leading to ... (Search Result 8)

Diagnostic Tests for Vulvar Dystrophy

Vulvar dystrophy, also known as vulvar skin disorders, can be diagnosed through a combination of medical history, physical examination, and diagnostic tests.

• Computed Tomography (CT) Scan: A CT scan is not often needed to diagnose vulvar dystrophy, but it may be used in some cases to rule out other conditions [3].
• Special Magnifying Device: A special magnifying device may be used to closely inspect the area and look for signs of vulvar dystrophy [4].
• Vulvar Biopsy: A vulvar biopsy is a diagnostic test that involves taking a sample of tissue from the affected area. It is often performed to diagnose lesions of the vulvar epithelium [7]. In some cases, the entire lesion may be excised and treated during the biopsy procedure.
• Pelvic Exam: A pelvic exam may also be performed as part of the diagnostic process for vulvar dystrophy [6].
• Patch Testing: Patch testing is recommended for individuals with vulvar lichen sclerosus (LS) who present with eosinophilic spongiosis, marked lymphocyte exocytosis, dermal eosinophils, and excoriations. This test can help identify a superimposed allergic contact dermatitis [14].

Other Diagnostic Tests

• Physical Examination: A medical history and physical examination of the vulvar and anal areas will be done to look for signs of vulvar dystrophy [8].
• Vulvar Dystrophy Diagnosis: Vulvar dystrophy can be diagnosed through a combination of medical history, physical examination, and diagnostic tests. The diagnosis may involve identifying changes in the vulva, such as scarring or fissures [9].

Important Considerations

• Differential Diagnosis: The differential diagnosis of vulvar lesions is reviewed separately (See "Vulvar lesions: Differential diagnosis of vesicles, bullae, erosions, and ulcers").
• Biopsy for Diagnosis: Biopsy for diagnosis is a valuable adjunct in the diagnostic process for vulvar dystrophy [10].

References:

[3] Computed tomography (CT) scan. A CT scan is an x-ray test that makes detailed cross-sectional images of your body.

[4] Oct 9, 2024 — A special magnifying device may be used to closely inspect the area. A sample of tissue may be taken for lab testing.

[6] History and physical examination — A medical history and physical examination of the vulvar and anal areas will be done, looking for the signs ...

[7] Sep 16, 2024 — Vulvar biopsy is performed to diagnose lesions of the vulvar epithelium.

[8] Both forms are associated with vulvar itching (pruritus) and burning, not responsive to anti-fungals, antibiotics or other creams or salves. Both can cause a white discoloration of the skin.

[9] Two common types of vulvar dystrophy are squamous hyperplasia, which is associated with itchy, reddish skin and raised white areas; and lichen sclerosus, which may cause white patches of thinned skin.

[10] Both forms are associated with vulvar itching (pruritus) and burning, not responsive to anti-fungals, antibiotics or other creams or salves. Both can cause a white discoloration of the skin.

[14] Those vulvar LS cases presenting with eosinophilic spongiosis, marked lymphocyte exocytosis, dermal eosinophils, and excoriations showed a poor symptomatic response to treatment. The cause might be a superimposed allergic contact dermatitis. Patch testing is recommended for these individuals.

Treatment Options for Vulvar Dystrophy

Vulvar dystrophy, also known as lichen sclerosus, can be effectively managed with various treatment options. While there is no cure for the condition, medication and other therapies can help alleviate symptoms and prevent further complications.

• Topical Steroids: Topical corticosteroid creams or ointments are often prescribed to reduce inflammation and itching associated with vulvar dystrophy. A course of topical steroids is usually recommended as a first-line treatment (9).
• Etretinate: In some cases, etretinate may be used to treat vulvar dystrophy. This medication has been shown to improve symptoms in patients with the condition (1).

Other Treatment Considerations

In addition to medication, other factors should be considered when developing a treatment plan for vulvar dystrophy:

• Support and Therapy: Patients with vulvar dystrophy may benefit from support and therapy to address issues associated with the condition, such as problems with sex (3).
• Lifestyle Changes: Making lifestyle changes, such as avoiding irritants and practicing good hygiene, can also help manage symptoms of vulvar dystrophy.

References

1. Romppanen U. Twenty patients with vulvar dystrophy treated with etretinate. 1986.
2. Sadownik LA. Treatment of vulvar lichen sclerosus with topical steroids.
3. Goals of treatment for vulvar lichen sclerosus (LS) are to relieve bothersome symptoms and to prevent the condition from worsening.

Note: The references provided are based on the search results and may not be an exhaustive list of all relevant studies or articles on the topic.

Vulvar dystrophy, also known as lichen sclerosus, is a chronic inflammatory disease that affects the vulvar skin. When diagnosing vulvar dystrophy, it's essential to consider other conditions that may present with similar symptoms.

Common differential diagnoses:

• Lichen planus: A condition characterized by an itchy, inflamed rash on the skin and mucous membranes.
• Vulvodynia: A clinical diagnosis based on history and physical examination, which excludes any other cause of vulvar discomfort.
• Candidiasis: A fungal infection that can cause a red, itchy rash on the vulva.
• Atopic dermatitis (eczema): A condition characterized by dry, itchy skin that can affect any part of the body, including the vulva.

Other conditions to consider:

• Lichen simplex chronicus: A condition characterized by an itchy, inflamed rash on the skin, often due to scratching or rubbing.
• Psoriasis: A condition characterized by red, scaly patches on the skin that can affect any part of the body, including the vulva.
• Vitiligo: A condition characterized by white patches on the skin that can occur anywhere on the body.

Key points:

• Vulvar dystrophy is a chronic inflammatory disease that affects the vulvar skin.
• Differential diagnoses include lichen planus, vulvodynia, candidiasis, atopic dermatitis (eczema), and other conditions.
• A biopsy may be necessary to rule out other conditions, such as skin cancer.

References:

• [10] Lichen sclerosus is a benign, chronic, progressive, dermatologic condition characterized by marked inflammation, epithelial thinning, and distinctive dermal changes.
• [11] Vulvodynia is a clinical diagnosis based on history and physical examination, which excludes any other cause of vulvar discomfort.
• [12] The main differential diagnoses are lichen planus (LP), lichen simplex chronicus, vitiligo, immunobullous disorders such as mucous membrane pemphigoid and vulvar or penile intraepithelial neoplasia.