What Every APP Should Know About Vulvar Dermatoses

“Really, no one likes to talk about vulvar symptoms… except vulvar derms,” Dr Melissa Mauskar began, launching into a rapid-fire, image-rich walkthrough of common vulvar dermatoses that APPs may encounter in her session, “Vulvar Dermatoses.”

From irritant contact dermatitis, often caused by “overcleaning” with wipes, soaps, or even water, to lichen sclerosus and lichen simplex chronicus, this session reminded clinicians that small interventions can yield major relief. “Ultrapotent topical steroids regularly for 4 to 12 weeks until texture normalizes” is the first-line approach for lichen sclerosus, Dr Mauskar emphasized, followed by a maintenance regimen to prevent progression and scarring.

One standout reminder: Do not trust labels like “sensitive” or “unscented.” In a study cited by Dr Mauskar, “almost all” tested wet wipes contained allergens, even those marketed as gentle. Instead, she recommends using plain water or “just pat with toilet paper” to minimize irritation.

Dr Mauskar also spotlighted the often-overlooked genitourinary syndrome of menopause, urging APPs to recognize changes in vulvar architecture and dryness that can mimic other dermatoses. “Estrogen is your friend,” she said, pointing to vaginal estrogen therapy as a 1A-level treatment supported by a growing safety profile, even in patients with prior breast cancer.

Rounding out the session, she offered pearls on lichen planus, a scarring condition that requires both dermatologic and gynecologic collaboration. “Don’t forget to look at the vulva,” she urged, noting that routine skin exams often skip this critical area where skin cancers and scarring diseases can hide.

Her takeaway? “You can make a big impact on these patients just by listening, asking, and looking.” A powerful reminder that vulvar dermatology belongs in every APP’s toolkit.

Reference

Mauskar M. Vulvar dermatoses. Presented at: Masterclasses in Dermatology APP Institute; October 11–12, 2025; Dallas, TX.