Vulvar lesions: Diagnostic evaluation
- Lynette J Margesson, MD, FRCPC, FAAD
Lynette J Margesson, MD, FRCPC, FAAD
- Assistant Professor of Surgery (Section of Dermatology) and Obstetrics and Gynecology
- Geisel School of Medicine at Dartmouth
- Hope K Haefner, MD
Hope K Haefner, MD
- Department of Obstetrics and Gynecology
- The University of Michigan Health System
- Section Editor
- Robert P Dellavalle, MD, PhD, MSPH
Robert P Dellavalle, MD, PhD, MSPH
- Section Editor — General Dermatology
- Professor of Dermatology and Public Health
- University of Colorado School of Medicine
- Colorado School of Public Health
- Chief, Dermatology Service
- US Department of Veterans Affairs
- Eastern Colorado Health Care System
A wide spectrum of benign, premalignant, and malignant lesions may occur on the vulva. The challenge to the clinician is to differentiate between normal variants, benign findings, and potentially serious diseases.
This topic will discuss the diagnostic evaluation of women with vulvar lesions. The differential diagnosis of vulvar lesions is reviewed separately. (See "Vulvar lesions: Differential diagnosis based on morphology".)
Ideally, the history is obtained before the patient undresses for her physical examination. In addition to a standard medical history, answers to the following questions can help identify possible causes of the vulvar lesion and exclude others. The answers to these questions may suggest a systemic disease rather than a primary localized vulvar disorder. The answers may also increase the clinician’s suspicion of dermatitis or infection as the etiology of the lesion.
●How long has the lesion been present? Was the onset sudden or gradual? Could it be related to trauma or another trigger?
●How did the lesion look when it first appeared? Is it different now? Does it come and go?
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