Vulvar melanoma is a rare malignant tumor of the female genital tract that affects mostly women in the 5th−8th decade of life. A histopathological evaluation and immunohistochemical analysis are paramount to confirm the diagnosis. Treatment requires a multidisciplinary approach. Secondary to a high metastatic potential as well as late diagnosis due to non-specific clinical signs, the prognosis is typically poor. Close monitoring, patient education regarding self-skin examination and screening are necessary for all atypical lesions and to identify local recurrences.

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.