Vulva Disorders

By Dr Ananya Mandal, MD

There are several disorders of the female reproductive system. Some of these are confined to the external female reproductive organs like the vulva. Gynaecologists deal with the diagnosis and treatment of the diseases and disorders associated with the female reproductive organs. Most women need to have regular examination of their vulva by self or by a gynaecologist to detect any abnormalities.

There are several disorders that may lead to abnormalities in appearance of the vulva.

These are classified as:

Causes of rashes, eruptions and plaques over the vulva:

  • Contact dermatitis - These are allergic reactions that may be caused due to perfumed or dyed toilet tissues, underwear, soaps, detergents, fabric softeners, talcum powder, hygiene sprays, spermicidal foams, creams, tablets, diaphragms etc.
  • Vulvar eczema
  • Infection due to Candida and yeast, tinea cruris etc.
  • Lichen simplex chronicus - Leads to symmetric, pigmentation, leathery, or coarse texture
  • Lichen sclerosus - Leads to plae patches and loss of elasticity
  • Lichen planus
  • Psoriasis - There are pink plaques

Causes of ulcers in the vulva

  • Vulvar cancer - Of types including squamous cell, basal cell carcinoma and melanoma
  • Infections with Herpes simplex, Epstein-Barr virus
  • Behcet’s, cicatricial pemphigoid ulcers
  • Aphthous ulcers
  • Pyoderma gangrenosum, anorectal ulcers, Crohn’s ulcers
  • Ulcers due to Syphilis, lymphogranuloma venereum, chancroid, donovonosis
  • Ulcers due to trauma or friction called decubitus ulcers and traumatic ulcers
  • Pemphigus vulgaris and Pemphigoid (mucus membrane pemphigoid, cicratricial pemphigoid, bullous pemphigoid)

Causes of lumps, cysts, tumours and nodules over the vulva -

  • Epidermal cysts
  • Infectious due to condyloma acuminatum, molluscum contagiosum
  • Swelling of Apocrine and eccrine gland including hidradenoma, Fox-Fordyce, syringoma
  • Swelling of the Keratinocytes including epidermal inclusion cyst, angiokeratoma, seborrheic keratosis
  • Swelling after trauma - posttraumatic hematoma
  • Swellings of mesenchymal origin including - lipoma, leiomyoma, fibroma, granular cell myoblastoma
  • Swellings and lumps which are embryological remnants including mucocele, mesonepthic duct cyst, Bartholin cyst, cyst of Canal of Nuck. Other congenital conditions include septate vagina, imperforate hymen, hermaphroditism etc.
  • Other swellings including minor vestibular adenoma, hemangioma and vulvar varicosities

Causes of blemishes

  • Moles
  • Freckles
  • Scars, Lentigos
  • Tattoos
  • Vitiligo patches
  • Hypertrophy

Causes of vulval pain or vulvodynia

  • Vulvodynia and vulvular vestibulitis
  • Vaginismus

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)

Sources

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