COLOUR ATLAS DISEASES VULVA

Designed to be helpful to the clinician, this work provides basic information on the aetiology, pathology and management of vulval lesions. Coverage includes child sexual abuse, since its signs are variable and easily confused with vulval disease.

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This atlas is intended to be helpful to the clinician, whether in genitourinary medicine, gynaecology or dermatology, who seeks guidance in vulval lesions. It cannot serve as a textbook on all aspects of aetiology, pathology and management but the text is written to supplement the pictures to the extent of providing some basic information. The rare conditions of varying aetiology presenting as ambiguous genitalia, and not strictly speaking diseases of the vulva, are noted as an important differential diagnosis of labial adhesions, a much commoner occurrence, but are not given detailed consideration; clearly such a condition would call for a referral to a particularly interested paediatrician or gynaecologist. Child sexual abuse is considered in some detail since its signs are variable and easily confused with vulval disease, eg lichen sclerosus. Rape however, which would present essentially with non-specific signs of trauma with or without infection and would depend otherwise on forensic evidence for diagnosis, is not.
It was decided not to design the atlas in sections on "red lesions" "white lesions" etc, an approach which is perhaps more reasonably (and easily) applied to wild flowers or to birds than to vulval conditions. Such terms to some extent devalue the essential need for exact morphological description of what is often a complex and dynamic situation. Two appendices sets out the current classification of non-infective neoplastic and non-neoplastic vulval diseases and the scheme it superseded, as well as the so far less well-categorized vulvodynia.