PITFALL D efinition —A sexually transmitted disease caused by the spirochete Treponema pallidum . Clinical Features Epidemiology Primary syphilis typically occurs in young, sexually active adults. Secondary and tertiary disease is much less common due to the effectiveness of antibiotic treatment of the primary infection. Secondary syphilis develops in weeks to months in untreated individuals. Tertiary syphilis will occur in one third of untreated individuals. You’re…

PITFALL D efinition —A chronic herpes simplex virus (HSV) infection lasting more than 1 month. Clinical Features Epidemiology This is the most common ulcerative disease of the genital tract in developed countries. A prevalence of upward of 20 million cases has been reported in the United States. Chronic erosive HSV infection can be seen in HIV-positive patients and is an AIDS-defining illness if the lesions last…

D efinition —An ulcerative sexually transmitted disease (STD) caused by the herpes simplex virus (HSV) (double-stranded DNA). Clinical Features Epidemiology The most common ulcerative disease of the genital tract in developed countries. A prevalence of upward of 20 million cases has been reported in the United States. Chronic erosive HSV infection can be seen in human immunodeficiency virus (HIV)–positive patients and is an AIDS-defining illness if…

D efinition —A viral infection of the skin (often sexually transmitted when involving the genital area) caused by a DNA poxvirus. Clinical Features Epidemiology Genital infection most commonly occurs in young, sexually active individuals. In this population it is commonly transmitted by sexual or fomite contact. Cases in children are generally not sexually transmitted. You’re Reading a Preview Become a Clinical Tree membership for Full access…

D efinition —Infection marked by a shift in the vaginal flora. Caused by a decrease in the normal lactobacilli and an increase in numerous other organisms ( Gardnerella vaginalis , Mobiluncus , Mycoplasma hominis , Prevotella , Porphyromonas , Bacteroides , and Peptostreptococcus ). Clinical Features Epidemiology Most commonly present in young, sexually active women; however, it can be seen across a wide age group. You’re…

D efinition —A fungal infection caused by any member of the Candida species of fungi. Clinical Features Epidemiology Very common, affecting up to 75% of females starting after menarche and increasing in incidence with peaks in the third or fourth decades. Predisposing factors include diabetes; immunocompromised state; and steroid, antibiotic, and oral contraceptive use. You’re Reading a Preview Become a Clinical Tree membership for Full access…

D efinition —The sensation of pain localized to the vulvar vestibule. Clinical Features Epidemiology Once thought to be a relatively rare condition, it is now known to affect millions of women. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition —A granulomatous, inflammatory bowel disease that may spread to involve other sites such as skin and mucosa. Clinical Features Epidemiology Seen in patients with Crohn's disease. Crohn's disease has no gender predilection and usually manifests in the second to third decade of life. Vulvar involvement may be contiguous (i.e., fistula formation) or may be isolated (metastatic Crohn's disease) with lower gastrointestinal symptoms. You’re Reading…

D efinition —A suppurative inflammatory process that can be associated with fistula tract or abscess formation. Clinical Features Epidemiology Most commonly seen in young women. The most common sites of involvement are the axilla and groin. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition —Hyperkeratosis marked by discrete, flesh- to white-colored papules to plaques. This entity overlaps with what is called acantholytic dyskeratosis (a term under which other dyskeratoses might fall). In this section we discuss a process that is encountered sporadically. Clinical Features Epidemiology Epidermolytic hyperkeratosis is an uncommon condition with no demographic predilections. You’re Reading a Preview Become a Clinical Tree membership for Full access and…

D efinition —Autosomal dominant genodermatosis marked by numerous hyperkeratotic papules that usually involve the trunk. Clinical Features Epidemiology Patients present around puberty; however, they can present later in life. Men are more severely affected; however, the incidence is equal in men and women. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member.…

D efinition —An autosomal dominant, acantholytic dermatosis with a predilection for moist body creases. Clinical Features Epidemiology It is a rare autosomal dominant disease. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition —An acquired autoimmune (anti–desmoglein 3 antibodies) blistering disorder that is marked by flaccid bullae and mucosal erosions. Clinical Features Epidemiology Incidence is rare and the disease may affect all age groups. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition —An autoimmune blistering disorder that is the most common cause of subepidermal blisters. Caused by antibodies to a 230 kD plakin (BPAg1) and a 180 kD glycoprotein (BPAg2). Clinical Features Epidemiology Primarily seen in older patients and is commonly associated with other autoimmune disorders (lupus, diabetes, primary biliary cirrhosis, ulcerative colitis, and alopecia areata). You’re Reading a Preview Become a Clinical Tree membership for Full access…

D efinition —Plasma cell–mediated vulvitis of unknown etiology. Clinical Features Epidemiology A rare condition. Has also been reported in men, as balanitis chronica circumscripta plasmacellularis. Age range is from 25 to 70 years, with middle-aged women most commonly being affected. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition —An uncommon idiopathic mucocutaneous inflammatory dermatosis with a prototypical lichenoid tissue reaction pattern, and a wide range of clinical presentations. Clinical Features Epidemiology Women at ages of 30 to 60 years. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition —A chronic inflammatory dermatosis of unknown etiology that commonly affects the vulva. Clinical Features Epidemiology More commonly seen in perimenopausal and postmenopausal patients; however, can be seen at any age. Associations have been made with vulvar intraepithelial neoplasia (VIN) and certain human leukocyte antigen (HLA) haplotypes. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership…

D efinition —A chronic, recurrent dermatitis occurring in areas where sebum is produced marked by red plaques with a yellow scale. Clinical Features Epidemiology Common. Affects all demographic groups. Immunosuppressed patients and patients with some chronic conditions (including congestive heart failure and Parkinson's disease) have more severe disease and may develop generalized seborrheic dermatitis. The disease characteristically flares in winter and spring, with the resolution of…

D efinition —A chronic, hyperproliferative, papulosquamous disorder with a relapsing course. Clinical Features Epidemiology Affects 1% to 2% of Caucasians. Onset is usually in the late 20s. A genetic component is likely, as first-degree relatives are also often affected. At least one third of the female patients have vulvar involvement, although isolated vulvar involvement is uncommon. You’re Reading a Preview Become a Clinical Tree membership for…

D efinition —A cutaneous reaction related to scratching, often superimposed on other dermatoses. Clinical Features Epidemiology Lichen simplex chronicus (LSC) is not a distinctive disease but a clinical and pathologic response to repeated physical trauma such as rubbing or scratching. Often superimposed on eczematous dermatitis. Also seen in patients who habitually scratch. In the absence of other pathology, it is termed neurodermatitis. More commonly seen at…