Vulval and vaginal symptoms are common after the menopause and are frequently assumed to be due to the normal physiological changes that occur at this time. However, there are several important dermatoses that can occur in this patient group which need accurate diagnosis and appropriate management. This review discusses the clinical features and basic management of some of the common vulval problems occurring after the menopause.
FistarolSKItinPH. Diagnosis and treatment of lichen sclerosus: an update. Am J Clin Dermatol2013; 14: 27–47.
7.
LeibovitzAKaplunVVSaposhnicovN. Vulvovaginal examinations in elderly nursing home residents. Arch Gerontol Geriatr2000; 31: 1–4.
8.
MeyrickTRHRidleyCMMcGibbonDH. Lichen sclerosus et atrophicus and autoimmunity. Br J Dermatol1988; 118: 41–46.
9.
KreuterAKryvosheyevaYTerrasS. Association of autoimmune diseases with lichen sclerosus in 532 male and female patients. Acta Derm Venereol2013; 93: 238–241.
10.
BhargavaKLewisFM. Lichen sclerosus occurring on vaginal mucosa secondary to uterine prolapse. J Obstet Gynecol2013; 33: 319–320.
11.
ZendellKEdwardsL. Lichen sclerosus with vaginal involvement. Report of 2 cases and review of the literature. Arch Dermatol2013; 149: 1199–1202.
12.
DirimAHasirciE. Labial fusion causing urinary incontinence and recurrent urinary tract infection in a postmenopausal female: a case report. Int Urogynecol J2011; 22: 119–120.
13.
WallaceHJ. Lichen sclerosus et atrophicus. Trans St John’s Hosp Dermatol Soc1971; 57: 9–30.
NeillSMLewisFMTatnallFM. British Association of Dermatologists’ guidelines for the management of lichen sclerosus 2010. Br J Dermatol2010; 163: 672–682.
16.
JonesRWScurryJNeillSM. Guidelines for the follow-up of women with vulvar lichen sclerosus in specialist clinics. Am J Obstet Gynecol2008; 198: 496.e1–3.
17.
PelisseMLeibowitchMSedelD. Un nouveau syndrome vulvo-vagino-gingival. Lichen plan erosive plurimuqueux. Ann Dermatol Venereol1982; 109: 797–798.
18.
LewisFMBogliattoF. Erosive lichen planus – a diagnosis not to be missed: a clinical review. Eur J Obstet Gynecol Reprod Biol2013; 171: 214–219.
19.
WilkinsonEJBrownHM. Vulvar Paget disease of urothelial origin: a report of three cases and a proposed classification of vulval Paget disease. Hum Pathol2002; 33: 549–554.
20.
PretiMMichelettiLMassobrioM. Vulvar Paget disease: one century after first reported. J Lower Gen Tract Dis2003; 7: 122–135.
21.
MacleanABMakwanaMEllisPE. The management of Paget’s disease of the vulva. J Obstet Gynecol2004; 24: 124–128.
22.
DelportES. Extramammary Paget’s disease of the vulva: an annotated review of the current literature. Aust J Dermatol2013; 54: 9–21.
23.
EdeyKAAllanEMurdochJB. Interventions for the treatment of Paget’s disease of the vulva. Cochrane Database Syst Rev2013; 10: CD009245.
24.
HendiABrodlandDGZitelliJA. Extramammary Paget’s disease: surgical treatment with Mohs micrographic surgery. J Am Acad Dermatol2004; 551: 767–773.
25.
KaramABerekJSStensonA. HER-2/neu targeting for recurrent vulvar Paget’s disease. A case report and literature review. Gynecol Oncol2008; 111: 568–571.
26.
WangLCBlanchardAJudgeDE. Successful treatment of recurrent extramammary Paget’s disease of the vulva with 5% topical imiquimod cream. J Am Acad Dermatol2003; 49: 769–772.
27.
LuytenASorgelPCladA. Treatment of extrmammary Paget disease of the vulva with imiquimod: a retrospective, multicenter study by the German Colposcopy network. J Am Acad Dermatol2014; 70: 644–650.
28.
Moyal-BarraccoMLynchPJ. 2003 ISSVD terminology and classification of vulvodynia: a historical perspective. J Reprod Med2004; 49: 772–777.
29.
ReedBDHarlowSDSenA. Relationship between vulvodynia and chronic comorbid pain conditions. Obstet Gynecol2012; 120: 145–151.
30.
MandalDNunnsDByrneM. Guidelines for the management of vulvodynia. Br J Dermatol2010; 162: 1180–1185.
