Signs in Vulval Disease

8
Signs in Vulval Disease


Clinical signs are the manifestation of disease and are visible findings, such as the presence of a lesion, or are elicited by specific examination, for example touch‐provoked tenderness. In some situations, the absence of a normal feature can be very important in reaching a diagnosis; this is particularly important in some of the scarring dermatoses that affect the vulva, such as lichen sclerosus.


It is important to understand the correct terminology in describing lesions (see Table 8.1), as this is helpful in describing cases to colleagues (Table 8.2) and also for documenting change of any disease over time.


Table 8.1 Terminology of vulval lesions.




































































Lesion Description Clinical example
Macule Flat area of discoloration <1 cm Melanosis
Papule Well circumscribed, raised and palpable lesions <1 cm in size Molluscum contagiosum
Nodule Raised, palpable lesion >1 cm SCC
Plaque Raised, palpable area Psoriasis
Vesicle Raised lesion <5 mm containing fluid Herpes simplex
Bulla Raised, fluid containing lesion >5 mm Bullous pemphigoid,
Pustule Lesions containing pus which may be infected or sterile Infected – folliculitis
Sterile – pustular psoriasis
Erosion Superficial loss of epidermis Erosive lichen planus
Ulcer Loss of whole epidermis and upper dermis Crohn’s disease
Fissure Linear split through epidermis and superficial dermis Vulval psoriasis
Comedone Plug of keratin stuck in a dilated pilo‐sebaceous duct. They may be ‘bridged’ with an area of epithelium between two lesions Hidradenitis suppurativa
Telangiectasia Visible dilatation of small cutaneous bloods vessels; blanch with pressure
Purpura Macular lesions containing blood that do not blanch with pressure
Ecchymosis Larger extravasation of blood Lichen sclerosus
Oedema Diffuse swelling of the tissue Crohn’s disease

Table 8.2 Describing vulval lesions.



































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Related posts:

  1. Symptoms in Vulval Disease
  2. Vulval Squamous Cell Carcinoma
  3. Psoriasis
  4. Disorders of Pigmentation on the Vulva

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Mar 15, 2018 | Posted by in OBSTETRICS | Comments Off on Signs in Vulval Disease

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Term Description Example
Atrophy Thinning of tissue – may affect the epidermis, dermis or both Lichen sclerosus
Annular Ring shaped Granuloma annulare
Circinate Circular Erythema marginatum
Crust Dried exudate Impetigo, staphylococcal infection, severe allergic contact dermatitis
Desquamation Superficial peeling of epidermis Post‐inflammatory change, staphylococcal scalded skin syndrome
Erythema Red colouration of the skin often with increased warmth, due to increased blood supply to the area Inflammation, infection
Excoriation Break in epidermis due to scratching