Clinical Images

The Normal Vulva

A Normal Vulva

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A normal vulva. The pigmented labia minora are separated to show the vestibule (pink) and the entrance to the vagina. The fourchette is at the bottom of the picture (at the back of the entrance to the vagina. The clitoris not seen in this photo. Please note there is a wide variation in normal appearances of the vulva.

A Normal Vulva (Clitoris and Hood)

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The clitoral hood (prepuce) is pulled back to show the body of the clitoris.

Epidermoid Cysts

Epidermoid Cyst of the left Labia Majora

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These are harmless cysts which are quite common. They are hard, yellow and vary in size, feeling like a grain of sand or a pea under the skin. They may discharge and disappear. Sometimes they can occur in clusters.

Genital Warts

Genital Warts – extensive involving the vulva and perianal area

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Genital warts are caused by infection with a virus called ‘human papillomavirus’ (HPV). There are over 100 different types of HPV and about 20 of these infect the genital tract. Certain types of HPV cause pre-cancer and cancer of vulva, vagina, cervix and anus but these are different from the types that cause genital warts.

Lichen Sclerosus

Vulval Lichen Sclerosus prior to treatment – usually itchy

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The skin is pale and white, crinkly and thickened (lichenified) through repeated scratching. Note the red area on the clitoris hood which represent a bruise (ecchymosis) - a sign of active disease. There is some anatomical loss on the right inner labia.

A Normal Vulva (Clitoris and Hood)

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The skin is pale and white, crinkly and thickened (lichenified) through repeated scratching. Note the red area on the clitoris hood which represent a bruise (ecchymosis) - a sign of active disease. There is some anatomical loss on the right inner labia. Whiteness, lichenification and fissuring (splitting) are noted at the fourchette.
This is a chronic inflammatory skin condition that affects women and female children and also men and boys. It is commonest in girls before puberty and women after the menopause but can and frequently does, occur at any age. The true incidence of lichen sclerosus (LS) is not known but affects at least one in a thousand women.

Lichen Simplex

Vulval Lichen Simplex

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Thickened (lichenified) skin of the labia majora but no whiteness or anatomical loss.

Pagets Disease

Long standing Vulval Pagets Disease

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Paget’s disease of the vulval skin is a cancer of cells from the skin glands (adenocarcinoma in situ) that has not yet invaded beyond the skin, and may be linked to a cancer nearby. It is uncommon.

Vulval Eczema/Vulval Dermatitis

Vulval Dermatitis

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A close up image of the inner thigh showing redness and scaling There are some yellow crusts indicating healing infection.

Vulval Intraepithelial Neoplasia (VIN)

Vulval Intraepithelial Neoplasia (VIN) of the Perineum

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Vulval intraepithelial neoplasia (VIN) of the perineum (area between the fourchette and anus) showing a variety of features (pallor, pigmentation, fissuring (splitting).

Vulval Intraepithelial Neoplasia (VIN) of the Upper Left Labia Majora

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In this case a discrete, white, lesion is seen.

Vulval Intraepithelial Neoplasia (VIN) Pigmented

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Vulval intraepithelial neoplasia (VIN) of the left lower labia majora, perineum and anus. In this case the lesions are pigmented.
VIN (Vulvar intraepithelial neoplasia, vulval precancer, vulval dysplasia) is a condition affecting the vulval and skin around the anus which is the skin equivalent of an abnormal cervical smear, abnormal cells are found in the top layer of the skin and have not yet invaded beyond the skin.