BGL - vulva

Most common benign solid tumor of the vulva.

○ Most commonly found in the labia majora

FIBROMA

TREATMENT:

● 2nd most frequent type of benign vulvar mesenchymal tumor

● Arises from the subcutaneous (fat) tissue of the vulva

● Most commonly located in periclitorally or within the labia majora

● Softer and usually larger than fibromas

Cut section:

● Smooth surface

● Tissue is gray-white

Cut substance is soft, yellow, and lobulated. It’s rubbery in consistency, unlike in fibroma that’s very firm

● Commonly referred to as a mole.

● Localized nest or cluster of melanocytes

● Arise from the embryonic neural crest and are present from birth

flat, elevated, or pedunculated. The borders are sharp, the color even, and the shape is symmetric.

diameter of most common _______ ranges from a 3 to 10 mm.

commonly 6 to 20 mm with one or more atypical features such as speckling of color, diffuse margination, additional red, white, or blue hues, and asymmetry.

● Most common small vulvar cysts

● Firm, smooth-surfaced, white, yellow, slightly pink, or skin-colored papules or nodules averaging 0.5 to 2 cm in size

● Most commonly located on the hair-bearing areas.

○ Asymptomatic, and no treatment is necessary.

○ If confirmation is needed, incision reveals white, caseous material, like thick cheese

○ With rupture or leakage of a cyst

○ is seen more on hair follicles and is common in women who shave → embedding of skin cells in the hair follicles → will be trapped → forming inclusion cysts.

○ Treatment: heat applied locally and possibly incision and drainage

○ Recurrent infection: Excision once inflammation subsides

CONTACT DERMATITIS

● Very common

● Caused by one of two pathophysiologic process:

○ Red, edematous inflamed skin; may become eczematoid

○ Can evolve into lichenification (whitish in color)

CONTACT DERMATITIS

MANAGEMENT:

● For primary, remove irritants or potential allergens

● Skin should be kept clean and dry

● Apply _______

● Tepid water bath soaks several times a day for the first few days

● Lubricating agent such as _______ to rehydrate skin

● If secondary to incontinence: _______ ointment or _______ and _______ ointment to keep urine and feces away from the skin

○ If secondary to urine or fecal continents, we need zinc oxide, like _______

● Approximately 20% of women with _______ have vulvar involvement

○ Scaling is less intense compared to other areas of the skin

● Usually affects intertriginous (sa mga singit areas)

● Clinical manifestation:

○ Red to red-yellow papules which may enlarge, becoming well-circumscribed, dull red papules.

Diagnosis:

○ Classic silver scales and bleeding on gentle scraping of the plaques

● Does NOT involve the vagina

PSORIASIS

Initial treatment:

● Uncommon and can involve the vagina

● Histology : degeneration of the basal layer, lymphocytic infiltrations of the dermis, epidermal acanthosis

LICHEN PLANUS

Management:

○ Potent topical steroid (e.g ________ BID)

○ Steroid suppositories intravaginally at night or oral steroids in postmenopausal women

○ Topical or systemic ________ replacement to avoid additional mucosal thinning

○________: to separate vaginal adhesions or uncover a buried clitoris

LICHEN PLANUS

For postmenopausal women we Monitor at periodic intervals: increased risk for vulvar ________