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Vulvar inflammatory disorders: A review

Vulvar inflammatory disorders (VID) are a miscellaneous group of non-infectious conditions of the vulvar area, which can be broadly classified based on etiology and pathology. Here, we discuss a few pertinent VID including vulvar dermatitis, psoriasis, lichen planus, and lichen sclerosus. This review will focus only on common VID, and a few rare conditions with characteristic features such as Crohn’s disease, plasma cell vulvitis, acantholytic disorder of genitocrural area, desquamative vulvitis, and atrophic vulvovaginitis. A thorough history taking and relevant investigations including dermoscopy and biopsy are relevant to proper diagnosis and management of VID. Early management of VID is essential since these conditions are prone to interfere with psychosexual functioning of the patient. Potent topical steroids are the first line management in most cases, followed by topical calcineurin inhibitors, emollients, and antihistamines. Vulvar area is resistant to steroid induced atrophy; hence, use of potent topical steroids does not pose a problem. Oral steroids or steroid sparing agents are used in resistant cases.