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Vulvar Dermatoses and Menopause

  • Joana Lyra
  • Pedro Vieira-Baptista
Chapter

Abstract

Vulvar dermat may have added an increased risk of missing oses are prevalent inflammatory conditions, frequently associated with itching and burning. The diagnosis is usually clinical but sometimes challenging due to superimposed or associated conditions. This challenge can be harder in postmenopausal women, as the signs and symptoms of vulvovaginal atrophy frequently overlap with those of a dermatosis. Recently, the creation of the “genitourinary syndrome of menopause” may have added an increased risk of missing vulvar diseases.

While these are benign conditions, some (lichen sclerosus and lichen planus) can increase the risk of vulvar cancer, through the pathway of vulvar intraepithelial neoplasia, differentiated type. Failing to recognize this is a missed opportunity to avoid vulvar cancer.

Vulvovaginal symptoms are a frequent cause of gynaecological referral, and dermatologic conditions should always be considered among the differential diagnosis. A systematic evaluation of the symptoms may simplify the diagnostic process.

The authors consider that the classification proposed by the International Society for the Study of Vulvovaginal Diseases (ISSVD), in 2006, and the 2011 terminology are both useful and complimentary tools in daily clinical practice.

In this chapter, the most common vulvar dermatoses encountered in postmenopausal women—lichen simplex chronicus, lichen sclerosus, lichen planus, psoriasis, and atopic and contact dermatitis—are reviewed. An evaluation of the state of the art regarding pathology, classification, and treatment is made.

Keywords

Lichen simplex chronicus Lichen sclerosus Lichen planus Psoriasis Atopic dermatitis Contact dermatitis Menopause Genitourinary syndrome of menopause Vaginal atrophy 

Notes

Conflict of Interest

No conflicts of interest to declare.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Joana Lyra
    • 1
  • Pedro Vieira-Baptista
    • 2
    • 3
  1. 1.Gynaecology and Obstetrics DepartmentCentro Hospitalar de São JoãoPortoPortugal
  2. 2.Hospital Lusíadas PortoPortoPortugal
  3. 3.Lower Genital Tract UnitCentro Hospitalar de São JoãoPortoPortugal

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