Abstract
Background:
Vulvar diseases are common in the general
population and have a negative impact on the
quality of life.
Objectives:
To describe our experience as
dermatologists in the management of vulvar
dermatosis consultations.
Methods:
A retrospective
observational study was conducted with
patients who attended monographic vulvar
consultations over a 5-year period. Clinical information was obtained from the
patient's charts.
Results:
148
women were studied. Their mean age was 43.24 years (standard deviation 15.15 years), with ages ranging from 4 months to 80 years. 53.4% of
patients took between 2 and 5 years to seek medical
attention for the first
time. The most frequent
diagnosis was
lichen sclerosus (41.9%), irritative
eczema of the
vulva (14.9%), and
lichen simplex chronicus (10.1%). 83.8% reported anogenital
itching, 66.2%
pain, and 45.9%
dyspareunia. The most frequently prescribed
treatment was ultra-potent topical
corticosteroids (
clobetasol propionate; 41.2%).
Patients with
lichen sclerosus were significantly older than those
who presented with any of the other
diseases. No differences were found in terms of either the
time of
disease evolution or in symptom presentation. Study
limitations:
Retrospective study.
Vulvar diseases with an infectious cause are usually managed in
primary care, therefore, were not included. All
patients were recruited from a single
private hospital which limits the comparisons with the
public health system.
Conclusions:
Vulvar diseases frequently occur and are associated with high
morbidity. It is essential to promote the development of specific vulvar
consultations in
hospitals. Specialties such as
dermatology,
gynecology,
urology, or physiotherapy must be part of these units.