Vulvar Disease: What Do You Know?

In this presentation on vulvar disease, the speaker, a dermatopathologist affiliated with the University of Maryland, shares experiences and case studies from her clinic. She emphasizes the importance of using proper anatomical terms with children, and the potential awkward situations that can arise from those discussions. The speaker discusses cases involving an 80-year-old patient with urethral burning, ultimately diagnosed with differentiated vulvar intraepithelial neoplasia (dVIN), revealing challenges in distinguishing between various vulvar pathologies. Another notable case involves a woman with lichen sclerosus who underwent a vulvectomy—surgery deemed unnecessary—leading to complications including pain from adhesions. The speaker stresses the need to avoid unnecessary surgeries and highlights the importance of appropriate treatment for conditions like lichen sclerosus, advocating for the use of topical steroids instead. The case of a 41-year-old woman with a vulvar lesion suspicious for high-grade squamous intraepithelial lesions (HSIL) underscores the significance of correct biopsy procedures and surgical decisions, especially when the patient faced a potential unnecessary vulvectomy. The speaker concludes by urging healthcare providers to educate and advocate for patients, emphasizing the importance of their quality of life and careful consideration when treating vulvar conditions.