Vulval disorders are not uncommon in obstetric practice. This chapter aims to enhance clinical skills in patient assessment, vulval examination and treatment of common benign vulval skin disease and infections. Basic treatments often benefit the patient (e.g. use of emollients and topical steroids). Some patients have complex disease and can present with more than one condition, so careful assessment and individualised management is essential. Understanding of when to refer onwards to a gynaecologist and even a vulval specialist service is important to optimise clinical outcomes.

In this chapter we have chosen to include the most common vulvar dermatoses: lichen sclerosis, lichen planus, lichen simplex chronicus, contact dermatitis, plasma cell vulvovaginitis, genital psoriasis, hidradenitis suppurativa and anogenital warts.

Lichen sclerosis is a chronic inflammatory skin disease most frequently seen in pre- or postmenopausal women. Lichen planus is an inflammatory condition of the skin and mucus membranes. Lichen simplex chronicus is a dermatosis found in areas of itching and scratching. Contact dermatitis is an allergic or irritative skin reaction caused by an exposure to an exogenic trigger. Plasma cell vulvovaginitis is a chronic, inflammatory skin disease. Genital psoriasis is an autoimmune chronic disorder of unknown cause. Hidradenitis suppurativa is a chronic, inflammatory skin disease characterized by abscesses, fistulas and scaring in intertriginous areas. Anogenital warts are sexually transmitted benign proliferative lesions caused by human papillomavirus.