ABSTRACT
Women with vaginal and vulvar dermatologic disease represent difficult diagnostic and therapeutic challenges for physicians. These are cutaneous problems that disrupt the patient's lifestyle. These women often present with complex clinical entities with the underlying dermatologic pathology aggravated by a secondary infection with either Candida or bacteria. There are many classes of immune responses that will influence the varied vulvovaginal epithelial pathology that can be encountered. The common immune problem associated with vulvar pathology is the induction of a Th2 immune response. The treatment of women with dermatologic lesions requires physician inquisitiveness, expertise, and patience. In many cases these can be aided by a close clinical partnership with an able dermatologist. After the diagnosis has been confirmed by biopsy, there can be multiple layers of disease that can be detected by careful observation and appropriate testing, with an emphasis upon the biopsy and consultation with dermatopathologists. A definitive diagnosis is needed for appropriate treatment planning.
