RESUMO
This article discusses the differential diagnosis of vulvar ulcers and describes a general clinical approach to this common but nonspecific examination finding. The differential diagnosis includes sexually and nonsexually transmitted infections, dermatitides, trauma, neoplasms, hormonally induced ulcers, and drug reactions. Patient history and physical examination provide important clues to the cause of a vulvar ulcer. However, laboratory testing is usually required for accurate diagnosis because the clinical presentation is often nonspecific and may be atypical due to secondary conditions.
Assuntos
Úlcera , Doenças da Vulva , Diagnóstico Diferencial , Feminino , Humanos , Úlcera/diagnóstico , Úlcera/etiologia , Úlcera/terapia , Doenças da Vulva/diagnóstico , Doenças da Vulva/etiologia , Doenças da Vulva/terapiaRESUMO
This article discusses the clinical evaluation and approach to patients with 3 complex ulcerative vulvar conditions: hidradenitis suppurativa, metastatic Crohn disease of the vulva, and aphthous ulcers. These conditions are particularly challenging to medical providers because, although each is known to present with nonspecific examination findings that vary in morphology, the predominance of the diagnosis is based on clinical examination and exclusion of a wide variety of other conditions. Care of patients with these conditions is further complicated by the lack of therapeutic data and the significant impact these conditions have on quality of life.
Assuntos
Doença de Crohn , Hidradenite Supurativa , Estomatite Aftosa , Úlcera/etiologia , Vulva/patologia , Doenças da Vulva/etiologia , Doença de Crohn/complicações , Doença de Crohn/diagnóstico , Doença de Crohn/terapia , Diagnóstico Diferencial , Feminino , Hidradenite Supurativa/complicações , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/terapia , Humanos , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/etiologia , Estomatite Aftosa/terapia , Úlcera/terapia , Doenças da Vulva/complicações , Doenças da Vulva/diagnóstico , Doenças da Vulva/terapiaRESUMO
Vulvar pruritus is a common and distressing condition for patients, and its presentation is often delayed and complicated by home remedies. The true prevalence cannot be accurately estimated. Vulvar pruritus is a symptom, and an underlying cause must be sought and not assumed. This is best accomplished by obtaining a careful history of vulvar care regimens and treatments, performing a detailed physical examination, and considering a broad differential diagnosis. This article provides a practical and clinical approach to the evaluation of vulvar pruritus and then focuses specifically on one common cause, lichen simplex chronicus.