Benign and Malignant diseases of Vulva

:Contents

1.Sign and symptoms of vulvar disease

2.Classification of vulvar diseases
3.Prevention
Common sign and symtoms of vulval
:diseases
:Symptoms
Itching.1
Burning sensation.2
Vaginal discharge or bleeding.3
:Signs
Redness.1
Swelling(lump).2
Skin lesions and ulcer.3
Factors predispose to vulvar diseases

 Sexual habit
 Systemic infections
 Diabetes mellitus
 Immunocompromised parients
 Antibiotics
 poor hygiene
Foreign body
 :Classification of vulval diseases

:A.Benign vulval diseases,include

Skin complaints.1
Infections.2
Benign tumors.3
Chronic pain.4
:B.Malignant vulval diseases,include
Squamous cell carcinoma.1
Adenocarcinoma.2
Melanoma.3
Sarcoma.4
Basal cell carcinoma.5
 :Benign vulval lesions

:Dermatitis
.Symptoms: chronic itching
Causes: direct contact with irritant such as hygiene products,
spermicidal creams, or due to an allergic reaction to a particular substance
.such as the latex used in condoms
:Treatment
Topical corticosteroid creams, antihistamines, and the identification and
.avoidance of known triggers
: Psoriasis

.Causing reddened, scaly patches

:Treatment
Topical steroid creams alternated with tar
preparations. Careful diagnosis is needed, since
.psoriasis is easily confused with dermatitis
 : Lichen planus

Symptoms include pain, bleeding and painful sex. Other areas

of the body may be affected by lichen planus, such as the
.hands, mouth and shins
:Treatment
Steroid creams or oral tablets. This condition is linked to an
.increased risk of vulval cancer
 Lichen sclerosus :

Atrophic dystrophys Symptoms include(itching and tenderness).

The vulva is wrinkled and covered in white patches.
Postmenopausal women are most susceptible. The cause is
thought to be an autoimmune response, since the condition is
associated with autoimmune disorders such as Graves’ disease and
vitiligo.

Diagnosis: biopsy
Treatment:
Topical steroid creams( testosterone cream) and regular medical
monitoring. Lichen sclerosus is linked to an increased risk of vulval
cancer.
 Candidiasis (thrush)

Symptoms(chronic itching, redness and vaginal

discharge).Thrush is caused by an overgrowth of the
fungi Candida albicans, which may occur after a course of
.antibiotics
.Treatment: antifungal creams
Recurrent vulvovaginal candidiasis – thrush is called
‘recurrent’ if the woman experiences at least four separate
.infections in one year
 :Genital herpes

This sexually transmitted infection (STI) causes blistering of the

infected skin. The blisters ulcerate after around five to 14 days.
There is no cure, but antiviral medications can reduce the frequency
.and severity of attacks
Genital warts:

This sexually transmitted infection (STI) causes warts to appear on the

affected areas. The warts can vary in size, shape and colour, and are
.usually painless
:Treatment
Removing the warts by freezing, burning or using topical chemicals.
Some forms of genital warts (Types 16 and 18) are linked to an
increased risk of cervical cancer
Benign tumours

bartholin gland cyst

Sebaceous gland cyst
Nevi
Fibroma
Hemangioma
:Bartholin gland cyst or abscess
When the openings of bartholin glands become obstructed,
causing fluid to back up into the gland. The result is relatively
painless swelling called a Bartholin's cyst. If the fluid within the
cyst becomes infected, may develop a collection of pus
.surrounded by inflamed tissue (abscess)
A Bartholin's cyst or abscess is common.The most common
microorganism are E.Coli,gonorrhea and chlamidya
:Treatment
Depends on the size of the cyst, how painful the
.cyst is and whether the cyst is infected
symptomatic treatment. In other cases, surgical
drainage of the Bartholin's cyst is necessary. If
an infection occurs, antibiotics may be helpful
.to treat the infected Bartholin's cyst
 :Chronic pain

:Vulvodynia
The vulva is painful for unknown reasons. Older women are at
increased risk. Theories on the cause of vulvodynia include
allergies, candidiasis (chronic thrush), nerve damage, muscle
.spasms and sexual problems. There is no cure
:Treatment
Aims to ease the symptoms and can include topical anaesthetic
creams, pain management. Tricyclic antidepressants are
.known to offer pain relief
 B.Malignant vulval lesions:
Squamous cell carcinoma.1
Most vulvar cancer (approximately 90%) is squamous cell
carcinoma, which originates from epidermal squamous
cells. Carcinoma-in-situ is a precursor lesion of squamous
cell cancer. This type of lesion is more common with older
.age
Squamous lesions tend to arise in a single site and occur
.most commonly in the vestibule

.
 Melanoma.2
is the second most common type of vulvar cancer and
causes 8-10% of vulvar cancer cases.These lesions arise
from melanocytes, most common in women 50-80 years
old.Melanoma of the vulva behaves like melanoma in
.any other location
Basal cell carcinoma.3
About 1-2% of vulvar cancer. These tend to be slow-growing
lesions on the labia majora but can occur anywhere on the
vulva. Their behavior is similar to basal cell cancers in other
locations. They often grow locally and have low risk for deep
.invasion or metastasis
:Others.4
:Less common like
Adenocarcinoma
Saecoma
 Sign and Symptoms,diagnosis and
treatment:
:Sign and Symptoms
Typically, a lesion presents in the form of a lump or ulcer and may be
associated with itching, irritation, local bleeding or discharge, in
.addition to pain with urination or dysparuenia
:Diagnosis
History.1
Local examination.2
Biopsy.3
:Treatment
Excision.1
Chemotherapy.2
Radiotherapy.3
Prevention of Vulval diseases:

.Avoid irritants.1
.Good hyeigene and wash regularly.2
.Dress appropriately.3
.Perform regular self-examinations.3
.Avoid to have multiple partner.4
Control diseases that increase risk of vulval.5
.diseases like:DM
.Good hydration.6
Any Questions?