Evaluation and Management of Vulvar Disease, An Issue of Obstetrics and Gynecology Clinics

Book excerpt: Vulvar disorders are prevalent but often overlooked conditions in the curricula of obstetrics and gynecology, dermatology, and primary care residency training programs. This has led many outpatient clinicians to feel unprepared to evaluate the patient with a vulvar complaint. Often patients with complex, chronic vulvar disorders have seen multiple providers in consultation before they are appropriately diagnosed and treated, leading to frustration amongst patients and providers alike as well as excessive health care costs. The goal of this issue is to present a practical review on vulvar disease for outpatient clinicians to improve patient care. The topics highlighted in this issue represent gaps in knowledge among residents, fellows, providers, and course and conference attendees. The issue begins with a general approach to the evaluation and management of vulvar disorders and then moves on to an article on vulvar pathology that will help clinicians obtain the most useful pathology reads from their biopsies. Also addressed are specific vulvar disorders or presenting findings that are common or challenging. A pelvic floor physical therapy colleague provides information on how this modality can help manage vulvar pain. The issue concludes with an article on hot topics in vulvar disease. In the last several years there has been a growing number of newly trained physicians committed to advancing patient care in the area of vulvar disease, and many of this issue’s authors are part of this group. This issue should serve as a useful resource in the office of any provider who evaluates patients with vulvar complaints.