Abdominal Dyspareunia 6 Acanthosis 50 Acanthosis Nigricans X, 99

Cambridge University Press 978-1-316-50895-4 — The Vulva 2nd Edition Index More Information

Index

abdominal dyspareunia 6 birthmarks 138 lichen sclerosus 136–37 acanthosis 50 haemangioma 138 diferential diagnosis 42 acanthosis nigricans x, 99–101 naevi 138–39 presentation 41, 136 acetic acid 11, 89, 122 blebs x, 102 sexual abuse 48 aclometasone 14, 44 boils 104–05 treatment 48, 137–38 aciclovir 75 botulinum toxin 129 molluscum contagiosum adalimumab 108 Bowenoid papulosis 89 92–93, 140 adolescents Bowen’s disease 53 naevi 138–39 labia minora size/asymmetry bullous pemphigoid 70–71 pinworm infestation 140 144 burning sensation 6 psoriasis 135–36 lichen sclerosus 48 psychological management See also children calcipotriol 27 144–45, 147 allergens 23–24 Campbell de Morgan spots x, pyramidal perineal allergic contact dermatitis 101 protrusion 143 19–20, 23–24 cancer. See vulval neoplasia sexual abuse 145–46, 156 alopecia areata x, 39 Candida albicans 17, 23, 29, staphylococcal folliculitis amoebiasis x 31, 45 140 amitriptyline 123 Candida glabrata 29, 31 vulvovaginitis 139–40 Amolin cream 27 candidiasis x cicatricial pemphigoid 70 anatomy 4–5 children 142 cidofovir 91 angiokeratoma x, 101 chronic 29–34 cigarette paper wrinkling 10 anti-androgens 107 and diabetes 33 clindamycin 64, 107 antifungals 19, 20 investigation 31 clinical presentation 5–6 candidiasis 32, 150 management 32–33 clitoris 10 drug interactions 32 myths 149–51 clobetasol 13, 14, 43, 44 tinea 29 and hormone-replacement colposcopy 11 topical 35 therapy 151 comedones x, 106, 107, 109 apareunia x, 6, 59 and oestrogen-replacement compliance 159 aphthae x, 64, 66 therapy 33, 151 corticosteroids oral 66 post-corticosteroid 47 aphthous ulceration 67 aphthous ulceration 64–67 presentation 30–31 dermatitis 24, 135 investigation 66 cantharidin 93 lichen sclerosus 43–44, management 67 cellulitis x, 17, 102, 107, 118, 137–38 presentation 66 139 potency 14 atopic dermatitis 17–18 chancroid x, 76 psoriasis 136 atopy x, 16, 18, 19 children 132–47 topical 13–14, 20, 158 atrophic vaginitis 119 birthmarks 138 prolonged use 36 autoimmune bullous disease haemangioma 138 corticosteroid dermatitis 69 naevi 138–39 20–21 autoimmune thyroiditis x, 39 dermatitis 133–35 corticosteroid phobia 13, 24 azoles diagnosis 146–47 counselling, referral for 160 prolonged use of 35 fungal infections 142 Crohn’s disease x, 7, 66, 67–68 See also individual drugs genital warts 141 cryotherapy for genital warts herpes simplex 141–42 91 Behc¸et’s disease 66, 67, intra-vaginal foreign bodies cyclic neutropenia 67 68–69 143 cyclosporin 108 Bepanthen ointment 27 labia minora cyproterone acetate 34, 108 betamethasone 14, 44 fusion 143 cysts, sebaceous 102–03 biopsy 11, 154, 157 size/asymmetry 144 cytokines x

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Index

depressed patients, vulval pain erythema x, 42, 45 follow-up 91 in 127 post-corticosteroid 47 HPV vaccination 89 dermatitis 16–25 erythema multiforme 73–74 management 90, 141 allergic contact 19–20 management 74 luorouracil 5% cream 91 atopic 17–18 presentation 73 green tea sinecatechins 91 children 133–35 erythromycin 107 imiquimod 90 corticosteroid 20–21 examination 9–10 ingenol mebutate 91 examination 17–18, 134 abnormalities 10 physician-administered investigation 134 speculum 11 treatments 91 irritant contact 19, 133 See also speciic conditions podophyllotoxin 90 management 21 extra-mammary Paget’s disease treatment of sex partners allergen identiication 34–35, 110–11 92 23–24 investigation 111 pregnancy 91 children 134–35 management 111 presentation 89, 141 environmental presentation 111 prevalence 87 modiication 22–23 psychological issues 92 superinfection 23 faecal incontinence 7, 19, grat-versus host disease 61 topical corticosteroids 24, 155 granuloma inguinale 76 135 famciclovir 75 green tea sinecatechins 91 presentation 17, 133 female reproductive tract 2 griseofulvin 29 seborrhoeic 18 feminine hygiene products 19 gynaecological history 7 dermatological history 6 Fenton’s procedure 129 gynaecology 153 dermoscopy x inasteride 108 desonide 14 issures 6, 10, 17, 76–77, haemangioma 132, 138 desquamation x, 17, 83, 134 122 Haemophilus inluenzae 140 desquamative inlammatory ixed drug eruption 71–73 haemorrhoids 7 vulvovaginitis (DIV) x, aetiology 71–72 Hailey–Hailey disease 71 61–64 investigation 72 halobetasol 14 investigation 63–64 management 72 hamartoma x management 64 presentation 72 herpes simplex 74–76 presentation 63 luconazole 23, 29, 32, children 141–42 diabetes mellitus and 151 investigation 75 candidiasis 33 luorouracil 5% cream 91 management 75–76 Dowling–Degos disease x, 101 lutamide 108 presentation 75 doxepin 123 follicle-stimulating hormone hidradenitis suppurativa x, doxycycline 67 11 105–08 dutasteride 108 folliculitis x, 104–05 aetiology 105 dyspareunia x, 6, 21 staphylococcal 140 diagnosis 107 abdominal 118 fomites x, 9, 140 management 107 atrophic vaginitis 119 Fordyce spots 10 medical therapy 107–08 examination 120, 128 formication 6 surgery 108 lichen planus 59 fourchette x, 10 presentation 106 management 24, 120, Fox–Fordyce disease x, 96 history taking 6–9 128–29 fungal infections HPV. See human nociceptive pain 119 children 142 papillomavirus non-nociceptive pain 119 See also candidiasis, tinea human papillomavirus 50, tampon insertion 128 87 vaginal 118–20 gabapentin 123 vaccination 89 gastroenterological history 7 See also genital warts eczema 16 genital herpes. See herpes hydrocortisone 120 emotional issues 155 simplex dermatitis 24 environmental modiication genital warts 86–92 hygiene 8 155 aetiology 87–89 hyperalgesia x, 117 epidermal naevi 98–99, 139 children 141 hypopigmentation Epstein–Barr virus 66 diferential diagnosis 89, post-inlammatory 52 erosions 6, 10 94–97 See also vitiligo 164

Index

imiquimod 90, 93, 141 diferential diagnosis 42, 61 mucosal petechiae. See immunotherapy in lichen epidemiology 39 petechiae sclerosus 47–48 follow-up 152 mupirocin 64 impetiginisation 17 genetic factors 40 musculoskeletal history 7 impetigo 140 investigation 41–42 Mycoplasma pneumonia 73 incontinence. See faecal myths 151–52 incontinence, urinary presentation 40–41 naevi xi incontinence children 41 children 138–39 inliximab 108 resumption of sexual activity epidermal 98–99, 139 ingenol mebutate 91 49 melanocytic 98 inguinal folds x, 95, 98, 101, treatment 43–48, 151 pigmented 138 106, 136 children and adolescents nerve supply 5, 114–15 International Society for the 48 neuroibromatosis xi Study of Vulvar Disease maintenance 45–46 neuropathic pain 123 (ISSVD) 113 remission 44–45 non-infective chronic intertriginous x, 90 side efects 46–47 vulvovaginitis. See intra-vaginal foreign bodies surgical 48 desquamative 143 topical therapy 43–44, inlammatory investigations 11 47–48 vulvovaginitis irritant contact dermatitis 19 lichen simplex chronicus. See non-lesional vulval pain irritants 4 licheniied dermatitis 116–17 irritation 6 licheniication 24, 27 non-sexual acute genital itch. See pruritus licheniied dermatitis 49–50 ulceration (NSAGU) xi, itraconazole 29, 32 Lipschutz¨ ulcer 66 66 liquor picis carbonis (LPC) 27 non-sexually acquired genital ketoconazole 32 lumps 85–112 ulceration. See aphthous Koebner phenomenon x, 41 benign 86 ulceration malignant 86 nortriptyline 123 labia minora 10 normal variants 85–86 fusion 143 See also speciic conditions obsessive patients, vulval pain size/asymmetry 144 lymphangiectases 102 in 127 labioplasty 144 lymphogranuloma venereum oestrogen laser therapy for genital warts x, 76 deiciency 119, 151 91 myths 151 latex allergy 20, 24 maceration xi, 7, 18, 143, 144, topical 35 leishmaniasis x, 76 150, 153 oestrogen-hypersensitivity lesional vulval pain 117–18 macules xi, 40, 42, 99 vulvitis 17, 34 lichen planus 13, 57–61 Malassezia 19 oestrogen-replacement therapy aetiology 59 marsupialisation xi, 108 and candidiasis 33, 151 diferential diagnosis 61 melanocytic naevi 98 examination 59 melanoma 43, 111 Paget’s disease, follow-up 60 melanosis vulvae 99 extra-mammary. investigation 59 metformin 108 See extra-mammary management 60 methotrexate 108 Paget’s disease surgical 60 methylisothiazolinone 20 pain. See vulval pain presentation 59 methylprednisolone 14, 44 panty liners 19 lichen sclerosus 11, 13, 37–49 metronidazole 64 papilloma xi aetiology 39 mid-stream urine 11 See also human associated diseases 39–40 molluscum contagiosum xi, papillomavirus associated malignancy 42 92–93 papillomatous xi, 89 post-treatment 43 children 140 papules xi, 21, 40, 54, 55, 58, children 136–37 investigation 93 89, 93 presentation 41, 136 management 93, 141 See also Campbell de sexual abuse 48 presentation 93 Morgan spots, treatment 48, 137–38 mometasone 14, 44 comedones conditions linked to 39 morphoea xi patch testing 11, 20 165

Index

patient information 157 pyramidal perineal protrusion stinging sensation 6 patient 143 medication-induced 158–59 beliefs 8 strawberry naevi. See categorisation 12 raloxifene 34 haemangioma pearly penile papules 96 rashes 16–36 striae xi, 45, 153, 158 pedunculated lesions xi, 94, dermatitis 16–25 Wickham’s 58 98 extra-mammary Paget’s surgery for vulval pain 129 pelvic loor 1, 3, 5 disease 34–35 Sutton’s ulcer 66 pemphigus 70–71 oestrogen-hypersensitivity symptoms 5 benign familial 71 vulvitis 34 syphilis 76 perioriicial dermatitis 20–21 pitfalls in therapy 35–36 syringoma xi, 97 pernicious anaemia xi psoriasis 25–28 petechiae 10, 11, 63, 80, tinea 28–29 tacrolimus 14, 24, 27, 47 82 referral tampon insertion, pain on 128 PFAPA syndrome 66, 67 counselling 160 telangiectasia xi, 14, 21 physiotherapy 125–26 diicult patients 160 terbinaine 29 dyspareunia 128 pain management 160 thrush. See candidiasis referral 159–60 physiotherapy 159–60 tinea 28–29 pigmentation 10 referred pain 1, 125 children 142 pimecrolimus 14, 24, rituximab, and genital topical corticosteroids. See 27 ulceration 73 corticosteroids pinworm infestation 140 rugosity xi, 10, 17, 89, 120, toxic epidermal necrolysis plasma cell vulvitis. See 134 73–74 desquamative management 74 inlammatory sebaceous adenitis xi, 109 transgender patients 4 vulvovaginitis sebaceous cysts 102–03 transmissibility of skin platelet-rich plasma, sebaceous glands, prominent disorders 156 intra-lesional 47 96 triamcinolone 14, 24, 44, 108 podophyllotoxin 90, 141 sebaceous hyperplasia xi, 96 tricyclic antidepressants 123 polyphenon E ointment 91 seborrhoeic dermatitis 18 tuberous sclerosus xi post-menopausal women seborrhoeic keratoses xi, 94 atopic dermatitis 18 seminal luid allergy 20 ulcers 10 oestrogen-replacement sexual abuse 127 ulcus vulvae acutum 66 therapy 33, 151 asking about 156 umbilicated xi prednisone 67 children 145–46 urinary incontinence 7, 19 pregabalin 123 and lichen sclerosus 48 and vulval irritation 134 pregnancy sexual function 155 urological history 7 angiokeratoma 101 sexually transmissible candidiasis 33 infections 156 vagina 1, 5 genital warts 91 skin biopsy. See biopsy vaginal dyspareunia 118–20 skin tags 95 skin tags 95 vaginal swab 11, 35 propranolol 138 somatoform disorder 126–27 vaginitis, persistent 79–83 pruritus xi, 6, 93 examination 126 deinition 79 lichen sclerosus 40 management 127 diferential diagnosis 80–81 psoriasis 25–28 presentation 126 examination 81–83 children 135–36 speculum examination 11 history taking 81 history taking 25 spironolactone 107 valaciclovir 75 management 27–28 spongiosis xi, 16, 50 vestibulectomy 129 myths 153 squamous cell carcinoma VIN. See vulval intra-epithelial psychiatric history 154 and lichen sclerosus 42, 47 neoplasia psychological history 8 stabbing pain 6 violaceous xi, 21 psychological management in staphylococcal folliculitis 140 vitiligo xi, 50–52 children 144–45, 147 Staphylococcus aureus 17, 23 investigation 51 pubic hair 10 folliculitis 104–05 management 52 pudendal nerve 114 Staphylococcus pyogenes 17, 23 presentation 51 punctum xi, 103 stenosis xi, 38, 59, 60, 62 segmental 51 166

Index

vulva 1 lesional 117–18 inlammatory anatomy 4 management 123–24 vulvovaginitis common variations 10, complementary therapy vulvodynia. See vulval pain 154 124 vulvovaginal candidiasis. See nerve supply 114 exercise 124 candidiasis vulval awareness 6 medical therapy 123–24 vulvovaginal disease vulval hyperpigmentation 99 physiotherapy 125–26 clinical presentation 5–6 vulval intra-epithelial neoplasia referred pain 125 symptoms 5 (VIN) 52–56, 109–10 myths 154 vulvovaginal dyspareunia 6 epidemiology 55 non-lesional 116–17 vulvovaginitis investigation 55 classiication 123 children 139–40 management 55, 110 pathophysiology 114–15 investigation 139 presentation 53–54, 110 presentation 116, 128 management 140 terminology 54 referred 125 presentation 139 vulval neoplasia 109, 156 sexual abuse 127 desquamative inlammatory extra-mammary Paget’s skin diseases causing 118 (DIV) x, 61–64 disease 110–11 somatoform disorder melanoma 43, 111 126–27 white lesions 37–56 suspicion of 109 specialist referral 160 human papillomavirus 50 vulval pain 4, 113–30 surgical treatment 129 lichen sclerosus 37–49 chronic 115–16 systems review 121 licheniied dermatitis 49–50 depressed/obsessive patients vulval papillomatosis 10, 95 VIN 52–56 127 vulval swab 11 vitiligo 50–52 diagnosis 130 vulvitis 18, 23, 26 Wickham’s striae 58 dyspareunia. See dyspareunia friction 19 examination 121–22 oestrogen-hypersensitivity Zoon’s vulvitis. See pain localisation 122 16, 17, 34 desquamative rash/lesion 122 Zoon’s/plasma cell. See inlammatory history 120–21 desquamative vulvovaginitis

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