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Chapter 3 - Red Vulval Rashes

Published online by Cambridge University Press:  10 August 2023

Gayle Fischer  and
Jennifer Bradford
Gayle Fischer
Affiliation:
University of Sydney
Jennifer Bradford
Affiliation:
University of Western Sydney
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Summary

The most common presentation of a vulval skin problem is an itchy red rash. This group includes inflammatory dermatoses, infections, hypersensitivity reactions and one malignancy.

Dermatitis, psoriasis and chronic vulvo-vaginal candidiasis are all very common causes of red, itchy rashes with variable degree of scaling. Corticosteroid-induced dermatitis occurs when moderate to potent topical corticosteroid is used for long periods of time. Tinea is uncommon and extra-mammary Paget’s disease and oestrogen-hypersensitivity vulvitis are rare.

On first sight, all of these conditions look much the same. A combination of history taking, investigation and response to therapy will ultimately enable a diagnosis and effective treatment.

Type
Chapter
Information
The Vulva
A Practical Handbook for Clinicians
 , pp. 16 - 36
Publisher: Cambridge University Press
Print publication year: 2023

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References

Further Reading

Fischer, G. (2012). Chronic vulvovaginal candidiasis: what we know and what we have yet to learn. Australasian J Dermatol, 53, 247–54.CrossRefGoogle ScholarPubMed
Fischer, G. O. (1996). The commonest causes of symptomatic vulval disease: a dermatologist’s perspective. Australasian J Dermatol, 37, 12–18.Google Scholar
Fischer, G., Bradford, J. (2011). Persistent vaginitis. BMJ, 343, 7314.Google Scholar
Fischer, G., Bradford, J. (2011). Vulvovaginal candidiasis in postmenopausal women: the role of hormone replacement therapy. J Lower Genital Tract Dis, 15, 263–7.CrossRefGoogle ScholarPubMed
Fischer, G. O., Ayer, B., Frankum, B. et al. (2000). Vulvitis attributed to estrogen hypersensitivity: report of 11 cases. J Reprod Med, 45, 493–7.Google ScholarPubMed
Fischer, G. O., Spurrett, B., Fischer, A. (1995). The chronically symptomatic vulva: aetiology and management. Br J Obstet Gynaecol, 102, 773–9.Google Scholar
Foote, C. A., Brady, S. P., Brady, K. L. et al. (2014) Vulvar dermatitis from allergy to moist flushable wipes. J Lower Genital Tract Dis, 18, E1.Google Scholar
Hong, E., Dixit, S., Fidel, P. et al. (2014). Vulvovaginal candidiasis as a chronic disease: diagnostic criteria and definition. J Lower Genital Tract Dis, 18, 31–8.Google Scholar
Jones, W. R. (1991). Allergy to coitus. Aust N Z J Obstet Gynaecol, 31, 137–41.CrossRefGoogle ScholarPubMed
Kapila, S., Bradford, J., Fischer, G. (2012). Vulvar psoriasis in adults and children: a clinical audit of 194 cases and review of the literature. J Lower Genital Tract Dis, 16, 364–71.CrossRefGoogle ScholarPubMed
O’Gorman, S. M., Torgerson, R. R. (2013). Allergic contact dermatitis of the vulva. Dermatitis, 24, 64–72.Google Scholar
Smith, S., Hong, E., Fearns, S., Blaszczynski, A., Fischer, G. (2010). Corticosteroid phobia and other confounders in the treatment of childhood atopic dermatitis explored using parent focus groups. Australasian J Dermatol, 51, 168–74.Google Scholar
Weidinger, S., Ring, J., Köhn, F. M. (2005). IgE-mediated allergy against human seminal plasma. Chem Immunol Allergy, 88, 128–38.Google Scholar

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