Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-25T11:59:01.908Z Has data issue: false hasContentIssue false

Chapter 8 - Vulvar Lesions and Eruptions

Published online by Cambridge University Press:  23 October 2024

By
Christina Kraus  and
Melissa Mauskar
Edited by
Laurie J. Mckenzie  and
Denise R. Nebgen
Laurie J. Mckenzie
Affiliation:
University of Texas MD Anderson Cancer Center, Houston
Denise R. Nebgen
Affiliation:
University of Texas MD Anderson Cancer Center, Houston
Get access

Summary

Cancer patients often have a variety of skin eruptions ranging from infections to irritant contact dermatitis. Reviewing gentle skin care and educating patients on potential side effects of various treatments, such as post-radiation dermatitis or vulvovaginal graft-versus-host disease, is beneficial. This chapter will focus on common vulvar conditions that may arise during cancer treatment such as infections (folliculitis, abscesses and furuncles, angioinvasive infections, herpesvirus and candidal infections), primary dermatoses (lichen sclerosus and lichen planus), and therapy side effects (genitourinary syndrome of menopause, lymphedema, acquired lymphatic anomaly, radiation dermatitis and recall, toxic erythema of chemotherapy, and immune-checkpoint inhibitor cutaneous toxicities). Additionally, considerations for vulvar biopsies are discussed.

Keywords

VulvarBiopsyDermatosesFolliculitisAbscessesAngioinvasive InfectionsCandidaLichen SclerosusLichen PlanusGenitourinary Syndrome of MenopauseToxic Erythema of ChemotherapyLymphedemaAcquired Lymphatic AnomalyRadiation DermatitisRadiation RecallVulvovaginal Graft-Versus-Host DiseaseImmune-Checkpoint Inhibitors
Type
Chapter
Information
Caring for the Female Cancer Patient
Gynecologic Considerations
 , pp. 117 - 131
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Edwards, L., Lynch, P. J. Genital Dermatology Atlas and Manual. 3rd ed. Wolters Kluwer; 2018.Google Scholar
Mauskar, M. M., Marathe, K., Venkatesan, A., Schlosser, B. J., Edwards, L. Vulvar diseases: Approach to the patient. J Am Acad Dermatol. 2020;82(6):1277–84. doi:https://doi.org/10.1016/j.jaad.2019.07.115CrossRefGoogle ScholarPubMed
Shulman, H. M., Cardona, D. M., Greenson, J. K., et al. NIH consensus development project on criteria for clinical trials in chronic graft-versus-host disease: II. The 2014 Pathology Working Group Report. Biol Blood Marrow Transplant. 2015;21(4):589–603. doi:https://doi.org/10.1016/j.bbmt.2014.12.031CrossRefGoogle ScholarPubMed
Sally, R., Shaw, K. S., Pomeranz, M. K. Benign “lumps and bumps” of the vulva: A review. Int J Women’s Dermatology. 2021;7(4):383–90. doi:10.1016/j.ijwd.2021.04.007CrossRefGoogle ScholarPubMed
Berger, A. P., Ford, B. A., Brown-Joel, Z., et al. Angioinvasive fungal infections impacting the skin: Diagnosis, management, and complications. J Am Acad Dermatol. 2019;80(4):883–98.e2. doi:https://doi.org/10.1016/j.jaad.2018.04.058CrossRefGoogle ScholarPubMed
Mauskar, M. M., Marathe, K., Venkatesan, A., Schlosser, B. J., Edwards, L. Vulvar diseases: Conditions in adults and children. J Am Acad Dermatol. 2020;82(6):1287–98. doi:10.1016/j.jaad.2019.10.077CrossRefGoogle ScholarPubMed
Krapf, J. M., Smith, A. B., Cigna, S. T., Goldstein, A. T. Presenting symptoms and diagnosis of vulvar lichen sclerosus in premenopausal women: A cross-sectional study. J Low Genit Tract Dis. 2022;26(3):271–5. doi:10.1097/LGT.0000000000000679Google ScholarPubMed
Kolitz, E., Gammon, L., Mauskar, M. Vulvar lichen sclerosus in women of reproductive age. Baylor Univ Med Cent Proc. 2021;34(3):349–51. doi:10.1080/08998280.2021.1885093Google ScholarPubMed
Lee, A., Bradford, J., Fischer, G. Long-term management of adult vulvar lichen sclerosus: A prospective cohort study of 507 women. JAMA Dermatology. 2015;151(10):1061–7. doi:10.1001/jamadermatol.2015.0643CrossRefGoogle ScholarPubMed
Cooper, S. M., Haefner, H. K., Abrahams-Gessel, S., Margesson, L. J. Vulvovaginal lichen planus treatment: A survey of current practices. Arch Dermatol. 2008;144(11):1520–1. doi:10.1001/archderm.144.11.1520CrossRefGoogle ScholarPubMed
Crean-Tate, K. K., Faubion, S. S., Pederson, H. J., Vencill, J. A., Batur, P. Management of genitourinary syndrome of menopause in female cancer patients: A focus on vaginal hormonal therapy. Am J Obstet Gynecol. 2020;222(2):103–13. doi:10.1016/j.ajog.2019.08.043CrossRefGoogle ScholarPubMed
Fischer, G., Bradford, J. Interactions between vulvovaginal disorders and urinary disorders: The case for an integrated view of the pelvis. Int J Women’s Dermatology. 2021;7(5 Part A):600–05.CrossRefGoogle ScholarPubMed
Bygdeman, M., Swahn, M. L. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas. 1996;23(3):259–63. doi:10.1016/0378-5122(95)00955-8CrossRefGoogle ScholarPubMed
Chambers, L. M., Herrmann, A., Michener, C. M., Ferrando, C. A., Ricci, S. Vaginal estrogen use for genitourinary symptoms in women with a history of uterine, cervical, or ovarian carcinoma. Int J Gynecol Cancer. 2020;30(4):515–24. doi:10.1136/ijgc-2019-001034CrossRefGoogle ScholarPubMed
Simon, J., Nachtigall, L., Ulrich, L. G., Eugster-Hausmann, M., Gut, R. Endometrial safety of ultra-low-dose estradiol vaginal tablets. Obstet Gynecol. 2010;116(4):876–83. doi:10.1097/AOG.0b013e3181f386bbCrossRefGoogle ScholarPubMed
Lethaby, A., Ayeleke, R. O., Roberts, H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2016;(8). doi:10.1002/14651858.CD001500.pub3Google Scholar
Luu, Y. T., Kimmis, B. D., Bodine, J. S., Gloyeske, N. C., Dai, H. Malignancy-associated acquired vulvar lymphangioma circumscriptum: A clinicopathologic study of 71 cases. J Cutan Pathol. 2022;49(5):426–33. Doi:10.1111/cup.14181CrossRefGoogle ScholarPubMed
Rosenthal, A., Israilevich, R., Moy, R. Management of acute radiation dermatitis: A review of the literature and proposal for treatment algorithm. J Am Acad Dermatol. 2019;81(2):558–67. doi:10.1016/j.jaad.2019.02.047CrossRefGoogle ScholarPubMed
Seité, S., Bensadoun, R.-J., Mazer, J.-M. Prevention and treatment of acute and chronic radiodermatitis. Breast cancer (Dove Med Press). 2017;9:551–7. Doi:10.2147/BCTT.S149752Google ScholarPubMed
Teng, X., Zhang, X., Zhi, X., et al. Risk factors of dermatitis during radiation for vulvar carcinoma. Precis Med Sci. 2022;11(3):106–10. doi:https://doi.org/10.1002/prm2.12077CrossRefGoogle Scholar
Jia, A. Y., Viswanathan, A. N. Vaginal necrosis: A rare late toxicity after radiation therapy. Gynecol Oncol. 2021;160(2):602–9. doi:10.1016/j.ygyno.2020.11.025CrossRefGoogle ScholarPubMed
Sweren, E., Aravind, P., Dembinski, R., et al. Radiation recall dermatitis following letrozole administration in patient with a remote history of radiation therapy. NPJ Breast Cancer. 2021;7(1):62. doi:10.1038/s41523-021-00271-3CrossRefGoogle ScholarPubMed
Kornik, R. I., Rustagi, A. S. Vulvovaginal graft-versus-host disease. Obstet Gynecol Clin North Am. 2017;44(3):475–92. doi:10.1016/j.ogc.2017.05.007CrossRefGoogle ScholarPubMed
Stratton, P., Turner, M. L., Childs, R., et al. Vulvovaginal chronic graft-versus-host disease with allogeneic hematopoietic stem cell transplantation. Obstet Gynecol. 2007;110(5):1041–9. doi:10.1097/01.AOG.0000285998.75450.86CrossRefGoogle ScholarPubMed
Grulich, A. E., van Leeuwen, M. T., Falster, M. O., Vajdic, C. M. Incidence of cancer in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet (London, England). 2007;370(9581):59–67. doi:10.1016/S0140-6736(07)61050-2CrossRefGoogle ScholarPubMed
Bolognia, J. L., Cooper, D. L., Glusac, E. J. Toxic erythema of chemotherapy: A useful clinical term. J Am Acad Dermatol. 2008;59(3):524–9. Doi:10.1016/j.jaad.2008.05.018CrossRefGoogle ScholarPubMed
Lu, A., Endicott, A., Tan, S. Y., et al. Toxic epidermal necrolysis-like toxic erythema of chemotherapy: 2 illustrative cases. JAAD case reports. 2021;15:56–9. doi:10.1016/j.jdcr.2021.07.010CrossRefGoogle ScholarPubMed
Fässler, M., Rammlmair, A., Feldmeyer, L., et al. Mucous membrane pemphigoid and lichenoid reactions after immune checkpoint inhibitors: Common pathomechanisms. J Eur Acad Dermatol Venereol. 2020;34(2):e112–e115. Doi:10.1111/jdv.16036CrossRefGoogle ScholarPubMed
Truong, K., Jones-Caballero, M., Chou, S., et al. Lichen sclerosus and immune checkpoint inhibitors: A case and review of the literature. Australas J Dermatol. 2022;64(1):158–61. doi:10.1111/ajd.13941Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×