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The Dermatologist's Perspective




It is increasingly common for gynaecologists and dermatologists to work in partnership in the diagnosis and management of diseases of the vulva and vagina. This is because understanding the fundamentals of dermatology applicable to the vulva and vagina has repeatedly been shown to be a valuable adjunct to the rationalisation of diagnosis, classification, investigation and management of disease. This eChapter describes these fundamentals in detail, describes the common dermatological conditions of the vulva, and provides guidance regarding contemporary treatment options.

The eChapter begins by describing the scope of concern for dermatologists, and breaks the skin down into three distinct components: the epidermis, comprised of keratinocytes, melanocytes and Langerhans’ cells; the Dermis, comprised of the upper papillary dermis and the reticular dermis and the Basement Membrane Zone. The importance of obtaining a correct dermatological history is emphasised, and the author then progresses to discuss the interpretation of the macroscopic pathology of the skin of the vulva. How disease affects the functions of the various components of the vulval skin is then reviewed, with specific emphasis placed upon alterations in keratinocyte function, oedema of the dermis and coagulation of tissue fluid, and how these may be manifest in clinical signs such as surface scale, blisters, ulcers, scaly skin and crust. This discussion is then extended to include an overview of the processes that lay behind such diseases as erythema, wheals, lichenification, erythemato-squamous lesions, hypo-pigmentation, atrophy blisters, and ulcers. The chapter concludes by providing guidelines for treatment options, including non-pharmacological approaches such as saline soaks and lubricant creams, and pharmacological options such as corticosteroids in their various forms.

This eChapter forms part of the Ausmed publication The Vulva and Vaginal Manual, edited by Graeme Dennerstein, James Scurry, John Brenan, David Allen and Maria-Grazia Marin. A richly illustrated and comprehensive guide to the identification and treatment of over 275 vulvovaginal diseases The Vulva and Vagina Manual is an invaluable resource especially suitable for:

  • Gynecologists
  • Dermatologists
  • General Practitioners
  • Obstetricians
  • Midwives
  • General nurses
  • Practice nurses
  • Nurse Practitioners

There are also 14 additional eChapters from The Vulva and Vaginal Manual available for members to download from the Ausmed website. Subscription also entitles members to access the full range of resources that compliment and build upon the material described within The Vulva and Vaginal Manual, including a richly populated catalogue of Audio Lectures, Fast Facts and Video Learning Activities on the topics of gynecology, obstetrics, oncology, women’s health and a wide range of other healthcare topics. Both members and non-subscribers alike may also purchase a hard copy of this book of from the Ausmed Education Online Bookstore, along with hard copies of the complimentary publication Gynecological Cancer Care: A Guide to Practice.


Contents include

  • Detailed descriptions of the three components of the skin: the epidermis, dermis and the Basement Membrane Zone.
  • Fundamentals of obtaining the dermatological history
  • Interpretation of the microscopic pathology of the skin, and how this pathology manifests itself in clinical features
  • Contemporary treatment options for diseases of the vulva and vagina
  • Pharmacological options for treatment: topical corticosteroids and antibiotics
  • Practical tips for diagnosis and treatment
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Author / Editor Biographies

MBBS and FACD.
John Brenan is a dermatologist practicing in Melbourne. He is a past President of the Australian College of Dermatology, consultant dermatologist to the Mercy Hospital for Women and the original dermatologist for the Dermogynaecology Clinic.
MBChB, MMed, PhD, FCOG (SA), FRANZCOG and CGO.
David Allen is a certified gynaecological oncologist practicing at the Mercy Hospital for Women and the Peter MacCallum Cancer Centre, East Melbourne. He is an Associate Professor in the Department of Surgery at the University of Melbourne.
MBBS and FRCPA.
James Scurry is one of Australia's leading gynaecological pathologists. He is a pathologist in Newcastle, New South Wales.
RFD, MBBS, FRCOG (UK) and FRANZCOG
Dr Dennerstein is an Obstetrician and Gynaecologist with medical expertise in the health of the vulva and vagina. He is the former Head of the Dermo-gynaecology Clinic at The Mercy Hospital for Women and co-author of the book entitled: The Vulva and Vagina Manual. He has lectured extensively on this topic, both internationally and nationally. Graeme has extensive experience in family planning and reproductive health. In 1971 he established the Family Planning and Infertility Clinic at the Western General Hospital in Melbourne, serving as its director until 1986. From 1980 to 1989 he was the ...
MAPS
Grazia Marin is a psychologist in private practice in Melbourne and past committee member and Education Officer of the Victorian Psychosexual Society. She is also a member of the International Society for the Study of Vulvovaginal Diseases and is serving on its Patient Education and Sexual Difficulties committees.

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