Diagnosis

The wide variety of vulval inflammatory conditions makes a full gynaecological history and examination essential.

Important points to include are:

The history and examination should cover:

• sexual activity: organisms may be transmitted at coitus e.g. treponemata
• other skin disorders
• vaginal discharge
• urinary incontinence
• any change in toiletries, soap powder, condom usage etc

The investigations include:

• a midstream urine should be tested for glucose and sent for microscopy, culture and antibiotic sensitivity analysis (M C and S)
• where there is a vaginal discharge, a high vaginal swab should be sent for M C and S
• skin scrapings or biopsies may be sent for histology and M C and S

Reference

1. Simonetta C, Burns EK, Guo MA. Vulvar Dermatoses: A Review and Update. Mo Med. 2015 Jul-Aug;112(4):301-7.