Overviews in dermatology, pathology, and gynecology
(refer to individual papers for additional references)

“Dystrophy ‘is no longer an acceptable term; the new ISSVD class/ication system lists spec’fic dernatologic disorders (i.e. !ichen sclerosus, lichen planus, squamous celi hvpetplasia, psoriasis, etc.).
Contact dermatitis:
• Margesson LJ. Contact dermatitis ofthe vulva.Dermatol Ther. 2004;17(l):20-7. Revie’w.
Lichen píanus:
• Moyal-Barracco M, Edwards L. Diagnosis and thcrapy ofanogenital lichen planus. Dermatol Ther. 2004;17:38-46.
• Rogers RS 3rd, Eisen D, Erosive oral lichen planus with genital lesions: the vulvovaginal-gingival syndrome and the peno-gingival syndrome. Dermatol Clin. 2003 ;21:91-8,vi-vii
Lichen sclerosus:
• Funaro D. Lichen selerosus: a review and practical approach. Dermatol Ther. 2004; 17(1 ):28-37. Review.
• Smith YR, llaeffier 11K. Vulvar lichen sclerosus : pathophysiology and treatrnent. Am J Clin Dermatol. 2004;5(2):105- 25. Review.
• Tasker GL. Wojnarowska F. Lichen sclerosus. Clin Exp Dermatol. 2003 Mar;28(2):128-33. Review.
Squamous celi hyperplasia:
• Lynch PJ. Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region. Dermatol Ther. 2004; 17(1): 8-19. Review.
• Virgili A, Bacilieri S, Corazza M. Managing vulvar lichen sirnplex chronicus. J Reprod Med. 2001 Apr;46(4):343-6.
Adclitional articles on vulvar inflammatory conditions:
• Dermatologic Therapy 2004:17(1)
Vulvar Jntraepithelial JVeoplasia(VJIV) replaces such terrns as Bowen ‘s disease, etythroplasia oJ Queyrat, carcinoma simplex, Bowenoidpapulosis, Bowenoid dysplasia, hyperplastic dystrophy with atypia. and condylomatous dysplasia, dysplasia, or carcinoma in situ. The ISSVD terminology for ViN has undergone a revision at the 2004 Congress. As
VIN 1 is poorlv reproducible, uncommon, and generallv represents reactive change or I-1PV effect, the term is not used in the new terminologv.
ISSVI) terminology for Squamous Vulvar Intraepithelial Neoplasia (2003)
1. VIN, usual type
a. V1N, warty type
b. VIN, basaloid type
c. VIN, mixed (wartyfbasaloid) type
2. VIN, differentiated type
Note: lhe occasionai example of VIN that cannot be classified into either of the above VIN categories (usual type and differentiated type) rnay be classified as VIN, unclassified lype. lhe rare VIN ofpagetoid type may be classified as such, or placed
iii this category
• Siden M, Jones RW, Wilkinson Ei, Preti M, Helier DS, Scurry J, Haefner H, Neili S. Squamous vulvar intraepithelial neoplasia. 2004 Modified Terminology, ISSVD Vulvar Oncology Subcommittee. 1. Reprod Med 200550:807-10.
• Hart WR. Vulvar intraepithelial neoplasia: historical aspects and current status. lnt J Gynecol Pathol 20:16-30; 2001.
• Jones RW. Vulval intraepithelial neoplasia: current perspectives. Eur 1 Gynaecol Oncol. 2001 ;22(6):393-402.
• Preti M, Mezzetti M, Robertson C, Siden M. Inter-observer variation in histopathological diagnosis and grading of vulvar intraepithelial neoplasia: results ofan European coliaborative study. BJOG. 2000 May;107(5):594-9.
• Yang B, Hart WR. Vulvar intraepithelial neoplasia of the simplex (differentiated) type: a clinicopathologic study including analysis of HPV and p53 expression.
Am 1 Surg Pathol. 2000 Mar:24(3):429-41.
The terminology for vulvar pain has undergone many changes throughout the years. The most recent terminology developed bv the ISSVD under the direction oíMicheline Moval-Barracco, MD and Reter J. Lynch, MDfollows:
ISSVD Terminology and Classification of Vulvar Pain (2003)
A) Vulvar Pain Related (o a Specific Disorder
1) Infectious
(e.g. candidiasis, herpes, etc.)
2) lnflammatory (e.g. lichen planus, imrnunobullous disorders, etc.)
3) Neoplastic (e.g. Paget’s disease, squamous ccli carcinoma, etc.)
4) Neurologic (e.g. herpes neuralgia, spinal nerve compression, etc.)
B) Vulvodynia
1) Generalized
a) Provoked
(sexual, nonsexual, or both)
b) Unprovoked
c) Mixed (provoked and
2) Localized (vestibulodynia, clitorodyma, hernivulvodynia, etc.)
a) Provoked (sexual, nonsexual, or both)
b) IJnprovoked
e) Mixed (provoked and unprovoked)
• Edwards L. Subsets of vulvodynia: overlapping characteristics. Journal of Reproductive Medicine. 2004;49( li): 883-7.
• Haefner, HK, Coilins, ME, Davis, GD, Edwards L, Foster DC, Heaton Hartmann E, Kaufman RH, Lynch, P1,
Margesson Li, Moyal-Barracco M, Piper C, Reed BD, Stewart EG and Wilkinson Ei The vulvodynia guideline. Journal of Lower Genital Tract Disease. 2005; 9(1 )
:40-5 1.
• Moyal-Barracco M. Lynch Pi. 2003 ISSVD terrninology and classification of vulvodynia: a historical perspective. Joumal of Reproductive Medicine. 2004;49( 10):
The Termino?ogv Committee presented a new classfication ofthe benign, non-infectious vulvar dermatoses to the ISSVD
meinbership ai the February 2006 Congress. This classflcation was accepied by the membership and the C’o,nmittee is at this time completing rhe manuscr(pt which contains the c1assficarion. This manuscript will be submittedforpublication shortly and
avaílable on our website afterpublication.
• Baggish MS. Colposcopy ofthe Cervix, Vagina, and Vulva: A Comprehensive Textbook Mosby, 2003.
• Black MM. McKay M, Braude PR, Vaughan Jones SA, Margesson LJ. Obstetric & Gynecologic Dermatology, 2nd Edition, CV Mosby, 2003
• Brown D. Benign Diseases ofthe Vulva and Vagina ,
Sth edition,Mosby-Year Book 2004
• Edwards L. cd Genital Dermatology Atlas. Lippincott Williams & Wilkins, 2004
• Fisher BK. Margesson Li: Genital Skin Disorders. Mosby, St. Louis , 1998.
• Fu YS, Pathology ofthe Uterine Cervix, Vagina and Vulva. WB Saunders, 2002
• Heiler DS.
The Lower Female Genital Tract-A Clinicopathologic Approach Williams & Wilkins, 1998
• Kaufman RH.
Faro S, Brown D. Benign Díseases ofthe Vulva and Vagina. 5th Edition Elsevier Mosby 2005
• Neill SM, Ridley CM.
The Vulva, 2nd edition Blackwell Science 1999
• Dennerstein, Scurry J, Brenan J, Alien D, Marin G.-The Vulva and Vaginal Manual, Taylor and Francis, 2005.