Therapies and nursing care of women with vulvar dermatologic disorders.

Vulvar dermatologic disorders are common among women, and prevalence increases with age. Treatment can provide women with symptomatic relief and can halt further progression of disease. Numerous therapies are available, and nurses who work with women across the life span should have an understanding of vulvar dermatologic disorders and therapeutic modalities. We provide an overview of general vulvar care, four vulvar dermatologic disorders, and common treatment modalities including topical and systemic pharmacologic management.

Pain at midlife.

Although menopause is a normal developmental milestone through which all women pass, the transition has been long associated with chronic pain conditions that may be more accurately viewed as secondary to aging. Clinicians need to understand management of pain problems women may experience. This article examines pain syndromes including headache, back pain, osteoarthritis, pelvic pain, vulvo-vaginal pain, and burning mouth syndrome.

Lichen sclerosus of the vulva in women: assessment, diagnosis, and management for the nurse practitioner.

PURPOSE: To describe the etiology, clinical manifestations, assessment, and management of vulvar lichen sclerosus (LS) in women. DATA SOURCES: Selected research and clinical articles in professional journals and online websites, peer review, educational technical bulletin from professional organization and the authors' professional clinical experiences. CONCLUSIONS: Vulvar LS can manifest with varied symptoms that may mimic other common vulvar disorders such as infections. Careful assessment of the vulva and biopsy of any suspicious skin changes are needed for diagnosis and management of vulvar LS. Treatment with high-potency topical corticosteroids may alleviate uncomfortable symptoms and reduce physical changes. Follow-up management is essential to check for progressing problems such as introital stenosis and to assess for skin changes that may indicate vulvar squamous cell carcinoma. IMPLICATIONS FOR PRACTICE: Accurate diagnosis and successful management of vulvar LS requires thorough assessment of the genitalia, knowledge of the disorder and appropriate treatment and follow-up management.

Vulvar dermatoses.

Dermatologic manifestations of vulvar disease can be confusing, the cause ambiguous, and the course of treatment long. Without a specific complaint, the vulva is often overlooked during a routine pelvic examination, and is often simply "the means to go through" in order to perform the routine Pap smear. The clinician must develop an awareness of the importance of dermatologic manifestations related to the vulva. A systematic approach is necessary to determine the pathogenesis and clinical behavior of vulvar conditions. This article will focus on identification of the various classifications of vulvar dermatoses, the causes of these conditions, differential diagnoses, accurate assessment, and management of cutaneous vulvar conditions.

Vulvovaginal conditions: social, psychological, and sexual considerations.

Women experiencing vulvovaginal conditions are affected socially, psychologically, and sexually. Although vulvovaginitis is a common women's health problem, these considerations are overlooked in the literature and, unfortunately, often in practice, as well. This article presents a discussion of the social, psychological, and sexual issues to be considered when treating women with vulvovaginal conditions, including implications for practice.

Practical tips for assessment and management of vulvar and vaginal human papillomavirus.

Human papillomavirus (HPV) infection has been strongly associated with intraepithelial neoplasia and cancers of the lower genital tract. Due to either better detection or increased incidence of this infection, there is a greater demand for colposcopy. Historically, clinicians have focused their colposcopic investigation on the cervix, often neglecting evaluation of the vulva and vagina. Because HPV is a multicentric disease, these areas should not be overlooked. Nurse colposcopists need to assess and manage women who have HPV-related vulvovaginal lesions that are either symptomatic or have the potential to advance to cancer.