**2.3 Vulvar intraepithelial neoplasia (VIN)**

*Depigmentation*

who wear tight clothing.

*2.1.3 Allergic/irritant dermatitis*

confirm the diagnosis [72–75].

abuse or psychosocial problems.

Dermatitis (patch tests)

Lichen sclerosus Lichen planus

Irritation due to vaginal excretion

depression. There are many causes of itching.

Infection (candida, luteum, filamentous worms)

**2.2 Pruritus**

*2.1.2.3 Intertrigo combined with candida infection*

Intertrigo is a wet inflammatory dermatitis, which can occur on any fold of the body because of the irritation of the exposed skin surfaces from friction between them. This is more likely to occur in women who are overweight but also in those

The skin is painful, often red and flaky, showing wetness and stretch marks. Weight loss, local hygiene, and local exposure to air, such as the use of socks and cotton lingerie instead of synthetic underwear, should be envisioned. Powders (e.g.,

Candida usually complicates intertrigo and should be treated as described according to clinical practice guidelines for the management of candidiasis [56, 57]. In order to relief the inflammation, since there is no candida infection, steroid creams may be used.

The skin of the vulva, and especially the opening of vagina, is often affected by dermatitis. Dermatitis can be irritating (nonimmune) or actually allergic (immuneinduced). Chemicals that cause skin hypersensitivity include, but are not limited to, cosmetics, perfumes, contraceptive lubricants, sprays, and vaginal washings. Detergents, dyes, softeners, bleaches, soaps, and bleach used to clean the underwear can also cause irritation. In severe cases, hypersensitivity may occur in topical

Women with contact dermatitis have an overgrowth inflamed vulva with eczema characters, and patch tests can reveal local irritants. Temporary relief can be achieved with lubricants of the vulva (e.g., Emulsiderm in a daily bath), softeners (e.g., local water creams), and topical corticosteroids (e.g., monthly treatment with Dermovate topical application). As before, nonresponsive lesions need biopsy to

The term pruritus describes an intense feeling of itching. It is more common in women over the age of 40 years, and symptoms are getting worse by stress or

It is important to stop the vicious cycle of irritation/itching cycle that is using strong local steroids for a short time in order to reduce the local inflammation induced by scratching. Applying strong steroid ointment daily for 3 weeks followed by 1% hydrocortisone cream once a day is useful, as well as soap substitutes (e.g., Oilatum). Irritants, cosmetics added to bath, and synthetic pantyhose, as well as soap substitutes, should be avoided, and comfortable cotton underwear should be used. The area should be gently dry (e.g., with a hairdryer). Antihistamines can also help. If depression coexists, it may require treatment [76–84].Reasons of vaginal pruritus

Biopsy may be necessary for diagnosis, as well as patch tests may be also helpful. If no cause is found, it may be worth considering the possibility of previous sexual

talc), astringents (e.g., zinc), or blocking agents in the area may also help.

application of anesthetic creams, as well as steroid preparations.

**40**

Eczema

The term VIN was proposed to include dysplastic lesions and vulvar squamous in situ cancer and replace terms such as: (a) Bowen's disease; (b) Bowen's papilloma; and (c) dystrophy with atypia.

Depending on the degree of maturation of the neoplastic epithelium and the extent of atypia, three VIN classes, from I to III, are defined just like in CIN.
