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Chapter 5 - Things That Ulcerate, Blister and Erode

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

Diseases of the vulva that are primarily erosive or ulcerative are uncommon. Notwithstanding, fissures or excoriations can occasionally complicate almost any dermatological disease of the vulva.

Common conditions such as dermatitis and psoriasis may become eroded by scratching, and allergic contact dermatitis often causes such severe oedema that blistering occurs.

Certain conditions, which are not usually ulcerative or bullous, may have rare variants that are, for example, the bullous variant of lichen sclerosus. Vulval cancer may ulcerate when advanced.

This chapter focuses on conditions where ulceration or erosion are a characteristic part of the disease. It is important to understand the difference between ulceration and erosion: ulceration means full-thickness loss of the epithelium, whereas erosion means partial-thickness epithelial loss.

Type
Chapter
Information
The Vulva
A Practical Handbook for Clinicians
 , pp. 57 - 75
Publisher: Cambridge University Press
Print publication year: 2023

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References

Further Reading

Bradford, J., Fischer, G. (2010). Desquamative inflammatory vaginitis: differential diagnosis and alternate diagnostic criteria. J Lower Genital Tract Dis, 14, 306–10.Google Scholar
Bradford, J., Fischer, G. (2013). Management of vulvovaginal lichen planus: a new approach. J Lower Genital Tract Dis, 17, 28–32.CrossRefGoogle ScholarPubMed
Bradford, J., Fischer, G. (2013). Surgical division of labial adhesions in vulvar lichen sclerosus and lichen planus. J Lower Genital Tract Dis, 17, 48–50.CrossRefGoogle ScholarPubMed
Dixit, S., Bradford, J., Fischer, G. (2012). Management of non-sexually acquired genital ulceration using oral and topical corticosteroids followed by doxycycline prophylaxis. J Am Acad Dermatol, 68, 797–802.Google Scholar
Farhi, D., Wending, J., Molinari, E. et al. (2009). Non-sexually related acute genital ulcers in 13 pubertal girls: a clinical and microbiological study. Arch Dermatol, 145, 38–45.CrossRefGoogle ScholarPubMed
Fischer, G. (2007). Vulvar fixed drug eruption. J Reprod Med, 5, 81–86.Google Scholar
Lehman, J. S., Bruce, A. J., Wetter, D. A. et al. (2010). Reactive nonsexually related acute genital ulcers: review of cases evaluated at Mayo Clinic. J Am Acad Dermatol, 63, 44–50.CrossRefGoogle ScholarPubMed
Newbern, E. C., Foxman, B., Leaman, D. et al. (2002). Desquamative inflammatory vaginitis: an exploratory case-control study. Ann Epidemiology, 12, 346–52.Google Scholar
Selva-Nayagam, P., Fischer, G., Hamann, I. et al. (2015). Rituximab causing deep ulcerative suppurative vaginitis/pyoderma gangrenosum Curr Infect Dis Rep, 17, doi: 10.1007/s11908-015-0478-5.Google Scholar
Simpson, R. C., Littlewood, S. M., Cooper, M. E. et al. (2012) Real-life experience of managing vulval erosive lichen planus: a case-based review and UK multicenter case note audit. Br J Dermatol, 167, 85–91.CrossRefGoogle ScholarPubMed

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