“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 uriprovoked)
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): 772-7.
ISSVI)
CLASSIFICATION OF VIJLVAR DERMATOSES (2006)
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.
MAJOR
PUBLICATIONS ON VULVAR DISEASE
•
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,
• 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.