Skip to main content
SpringerLink
Log in

Hypo and Hyperpigmentary Disorders of Vulva

  • Chapter
  • First Online:
Aesthetic and Regenerative Gynecology

  • 1039 Accesses

Abstract

The vulva is a significant organ that was left unattended for a long time only to look at it carefully until it is diseased. Recent changes in women empowerment, instrumentation, and scientific advancement, drawn attention not only towards early diagnosis and treatment of female genital disease but also to its cosmetic enhancement. Diagnosing a vulval disease demand a careful examination of the private parts, and this needs a blend of social skill, scientific mind, clear-cut knowledge, and earned faith with the subject. All vulvar diseases are out of the scope of this chapter, and hence our discussion will be limited to pigmentary disorders of female external genitalia. 1 out of 10 women face pigmented lesions on their vulva though most of them are physiological and benign, yet knowledge about some treatable diseases is essential to avoid unnecessary cosmetic intervention and avoidance of disfigurement or severe disease upon delaying exact treatment [1]. Attention to vulval diseases are given only when its having diseases. Diagnosis of genital skin issues needs social skill, scientific mind, good knowledge. Recent interest in cosmetic enhancement of the area also demands skilful procedural dermatological intervention. Most of the diseases of vulva are treatable if detected at proper time. Lichen simplex et atrophicus (LSA) can lead to disfigurement and carcinoma if not treated early; and confusion with vitiligo is a rule in early disease. Hyperpigmentation on that region is mostly benign but melanoma to be rules out and need detail examination and or further investigation. A knowledge of vulval anatomy & physiology of different age is of utmost importance for accurate diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rock B, Hood AF, Rock JA. Prospective study of vulvar nevi. J Am Acad Dermatol. 1990;22(1):104e6.

    Article  Google Scholar 

  2. Friedrich E, Burch K, Bahr J. The vulvar clinic: an eight-year appraisal. Am J ObstetGynecol. 1979;135:1036e40.

    Google Scholar 

  3. Lynch PJ. Pigmented disorders. In: Edwards L, Lynch PJ, editors. Genital dermatology atlas. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2010. p. 170e85.

    Google Scholar 

  4. Ball SB, Wojnarowska F. Vulvar dermatoses: lichen sclerosus, lichen planus, and vulval dermatitis/lichen simplex chronicus. In Seminars in cutaneous medicine and surgery. 1998;17(3):182–8.

    Article  CAS  Google Scholar 

  5. McKay M. Vulvodynia versus pruritus vulvae. Clin Obstet Gynecol. 1985;28(1):123–33.

    Article  CAS  PubMed  Google Scholar 

  6. Carlson JA, Lamb PM, Malfetano J, Ambros RA, Mihm MC. Clinicopathologic comparison of vulvar and extragenital lichen sclerosus: histologic variants, evolving lesions, and etiology of 141 cases. Mod Pathol. 1998;11(9):844–54.

    CAS  PubMed  Google Scholar 

  7. Stewart KMA. Clinical care of vulvar pruritus, with emphasis on one common cause, lichen simplex chronicus. Dermatol Clin. 2010;28(4):669–80.

    Article  CAS  PubMed  Google Scholar 

  8. Thorstensen KA, Birenbaum DL. Recognition and management of vulvar dermatologic conditions: lichen sclerosus, lichen planus, and lichen simplex chronicus. J Midwifery Womens Health. 2012;57(3):260–75.

    Article  PubMed  Google Scholar 

  9. Moyal-Barracco M, Edwards L. Diagnosis and therapy of anogenital lichen planus. Dermatol Ther. 2004;17:38–46.

    Article  PubMed  Google Scholar 

  10. Ridley CM. Chronic erosive vulval disease. Clin Exp Dermatol. 1990;15:245–52.

    Article  CAS  PubMed  Google Scholar 

  11. Fischer G. Vulvar fixed drug eruption. J Reprod Med. 2007;52:81–6.

    PubMed  Google Scholar 

  12. Arnold AW, Häusermann P, Bach S, Bircher AJ. Recurrent flexural exanthema (SDRIFE or baboon syndrome) after administration of two different iodinated radio contrast media. Dermatology. 2007;214(1):89–93.

    Article  CAS  PubMed  Google Scholar 

  13. Ozdemir S, Kepil F, Erkekol O, Aydin O, Celik GE, Misirligil Z. Fixed drug eruption due to meloxicam. J Investig Allergol Clin Immunol. 2011;21(5):419.

    CAS  PubMed  Google Scholar 

  14. Wain EM, Neill S. Fixed drug eruption of the vulva secondary to fluconazole. Clinical and Experimental Dermatology: Viewpoints in dermatology. 2008;33(6):784–5.

    Article  CAS  Google Scholar 

  15. Margesson LJ. Contact dermatitis of the vulva. Dermatol Ther. 2004;17:20–7.

    Article  PubMed  Google Scholar 

  16. Crone AM, et al. Aetiological factors in vulvar dermatitis. J Eur Acad Dermatol Venereol. 2000;14:181–6.

    Article  CAS  PubMed  Google Scholar 

  17. Brenan JA, et al. Evaluation of patch testing in patients with chronic vulvar symptoms. Australas J Dermatol. 1996;37:40–3. Margesson LJ. Contact dermatitis of the vulva. Dermatol Ther2004;17:20–7. https://doi.org/10.1111/j.1396-0296.2004.04003.x.

    Article  CAS  PubMed  Google Scholar 

  18. Haverhoek E, Reid C, Gordon L, et al. Prospective study of patch testing in patients with vulval pruritus. Australas J Dermatol. 2008;49:80–5. https://doi.org/10.1111/j.1440-0960.2008.00442.x.

    Article  PubMed  Google Scholar 

  19. Bhate K, Landeck L, Gonzalez E, Neumann K, Schalock PC. Genital contact dermatitis: a retrospective analysis. Dermatitis. 2010;21(6):317–20.

    Article  PubMed  Google Scholar 

  20. Edwards L. Pigmented vulvar lesions. Dermatol Ther. 2010;23(5):449–57.

    Article  PubMed  Google Scholar 

  21. Moyal-Barracco M, Wendling J. Vulvar dermatosis. Best Practice & Research Clinical Obstetrics &Gynaecology. 2014;28(7):946–58.

    Article  Google Scholar 

  22. Venkatesan A. Pigmented lesions of the vulva. Dermatol Clin. 2010;28(4):795–805.

    Article  CAS  PubMed  Google Scholar 

  23. Grasinger CC, Wild RA, Parker IJ. Vulvar acanthosis nigricans: a marker for insulin resistance in hirsute women. Fertil Steril. 1993;59(3):583–6.

    Article  CAS  PubMed  Google Scholar 

  24. Puri N. A study of pathogenesis of acanthosis nigricans and its clinical implications. Indian J Dermatol. 2011;56(6):678.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Mikhail GR, FachnieD’Anne M, Drukker BH, Farah R, Allen HM. Generalized malignant acanthosis nigricans. Arch Dermatol. 1979;115(2):201–2.

    Article  CAS  PubMed  Google Scholar 

  26. Kellett HA, Collier A, Taylor R, Sawers JSA, Benton C, Doig A, Baird D, Clarke BF. Hyperandrogenism, insulin resistance, acanthosis nigricans, and systemic lupus erythematosis associated with insulin receptor antibodies. Metabolism. 1988;37(7):656–9.

    Article  CAS  PubMed  Google Scholar 

  27. Rock B. Pigmented lesions of the vulva. Dermatol Clin. 1992;10(2):361–70.

    Article  CAS  PubMed  Google Scholar 

  28. Alam M, Stiller M. Direct medical costs for surgical and medical treatment of condylomata acuminata. Arch Dermatol. 2001;137(3):337–41.

    CAS  PubMed  Google Scholar 

  29. Rock B, Hood AF, Rock JA. Prospective study of vulvar nevi. J Am Acad Dermatol. 1990;22(1):104–6.

    Article  CAS  PubMed  Google Scholar 

  30. El Shabrawi-Caelen L, Soyer HP, Schaeppi H, Cerroni L, Schirren CG, Rudolph C, Kerl H. Genital lentigines and melanocytic nevi with superimposed lichen sclerosus: a diagnostic challenge. J Am Acad Dermatol. 2004;50(5):690–4.

    Article  PubMed  Google Scholar 

  31. Mannone F. Vincenzo De Giorgi, Antonio Cattaneo, Daniela Massi, Angelina De Magnis, and Paolo Carli. “Dermoscopic features of mucosal melanosis.”. Dermatol Surg. 2004;30(8):1118–23.

    PubMed  Google Scholar 

  32. Barnhill RL, Albert LS, Shama SK, Goldenhersh MA, Rhodes AR, Sober AJ. Genital lentiginosis: a clinical and histopathologic study. J Am Acad Dermatol. 1990;22(3):453–60.

    Article  CAS  PubMed  Google Scholar 

  33. Nogita T, Mitsuhashi Y, Takeo C, Tsuboi R. Removal of facial and labial lentigines in dyschromatosis universalis hereditaria with a Q-switched alexandrite laser. J Am Acad Dermatol. 2011;65(2):e61–3.

    Article  PubMed  Google Scholar 

  34. Erkek E, SeldaHizel CS, Erkek AB, Tombakoglu M, Onder Bozdogan SU, Akarsu C. Clinical and histopathological findings in Bannayan-Riley-Ruvalcaba syndrome. J Am Acad Dermatol. 2005;53(4):639–43.

    Article  PubMed  Google Scholar 

  35. Lodish MB, Stratakis CA. The differential diagnosis of familial lentiginosis syndromes. Familial Cancer. 2011;10(3):481–90.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Blume-Jensen P, Hunter T. Oncogenic kinase signalling. Nature. 2001;411(6835):355–65.

    Article  CAS  PubMed  Google Scholar 

  37. Murzaku EC, Penn LA, Hale CS, Pomeranz MK, Polsky D. Vulvar nevi, melanosis, and melanoma: an epidemiologic, clinical, and histopathologic review. J Am Acad Dermatol. 2014;71(6):1241–9.

    Article  PubMed  Google Scholar 

  38. Sturgeon SR, Brinton LA, Devesa SS, Kurman RJ. In situ and invasive vulvar cancer incidence trends. Am J Obstet Gynecol. 1992;166:1482–5.

    Article  CAS  PubMed  Google Scholar 

  39. Trone JC, Guy JB, Mery B, LangrandEscure J, Lahmar R, Moncharmont C, et al. Melanomas of the female genital tract: state of the art. Bull Cancer. 2014;101:102–6.

    Article  PubMed  Google Scholar 

  40. Rigel DS, Friedman RJ, Kopf AW, Polsky D. ABCDE—an evolving concept in the early detection of melanoma. Arch Dermatol. 2005;141(8):1032–4.

    Article  PubMed  Google Scholar 

  41. Chatterjee S. Debangshu Dey, Sugata Munshi, and SurajitGorai. “Extraction of features from cross correlation in space and frequency domains for classification of skin lesions.”. Biomedical Signal Processing and Control. 2019;53:101581.

    Article  Google Scholar 

  42. Kara M. E. Colgecen, and Erdogan Nilsen Yildirim. “Vulvar basal cell carcinoma.”. Indian J Pathol Microbiol. 2012;55(4):583.

    Article  PubMed  Google Scholar 

  43. Rambhia K, Shah V, Singh R. Dermoscopy of pigmented basal cell carcinoma. Pigment International. 2018;5(2):123–4.

    Google Scholar 

  44. Deepadarshan K, Mallikarjun M, Abdu Noshin N. Pigmented basal cell carcinoma: a clinical variant, report of two cases. J Clin Diagn Res. 2013;7(12):3010.

    Google Scholar 

  45. Sarhan D, Mohammed GFA, Gomaa AHA, Eyada MMK. Female genital dialogues: female genital self-image, sexual dysfunction, and quality of life in patients with vitiligo with and without genital affection. J Sex Marital Ther. 2016;42(3):267–76.

    Article  PubMed  Google Scholar 

  46. Parsad D. Mucosal vitiligo. In: Vitiligo. Berlin, Heidelberg: Springer; 2010. p. 57–9.

    Chapter  Google Scholar 

  47. Nair PA. Vulvar lichen sclerosus et atrophicus. Journal of mid-life health. 2017;8(2):55.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Ridley CM. Lichen sclerosus et atrophicus. Arch Dermatol. 1987;123(4):457–60.

    Article  CAS  PubMed  Google Scholar 

  49. Barker LP, Gross P. Lichen sclerosus et atrophicus of the female genitalia: a clinical study and diagnostic guide. Arch Dermatol. 1962;85(3):362–73.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Apollo Hospitals, Kolkata, India

    Surajit Gorai & Koushik Lahiri

Authors
  1. Surajit Gorai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Koushik Lahiri
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. The Touch, Advanced Obstetrics, IVF & Cosmetic Gynae Centre, Mohali, India

    Preeti Jindal

  2. Global Rainbow Healthcare, Agra, Uttar Pradesh, India

    Narendra Malhotra

  3. City Clinic - International, Mahboula, Kuwait

    Shashi Joshi

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gorai, S., Lahiri, K. (2022). Hypo and Hyperpigmentary Disorders of Vulva. In: Jindal, P., Malhotra, N., Joshi, S. (eds) Aesthetic and Regenerative Gynecology. Springer, Singapore. https://doi.org/10.1007/978-981-16-1743-0_19

Download citation

  • DOI: https://doi.org/10.1007/978-981-16-1743-0_19

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-1742-3

  • Online ISBN: 978-981-16-1743-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation