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Vulvar lesions: Diagnostic evaluation

Lynette J Margesson, MD, FRCPC, FAAD
Hope K Haefner, MD
Section Editor
Robert P Dellavalle, MD, PhD, MSPH
Deputy Editor
Kristen Eckler, MD, FACOG


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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Literature review current through: Sep 2017. | This topic last updated: Dec 14, 2016.
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