Dr. Hall is one of the few gynecologists in the Washington DC area who specialize in disorders of the vulva. This has been an ongoing area of interest of hers for the past 20 years, leading to additional certifications and many years of experience. Dr Hall is considered an expert diagnostician of vulva disorders, seeing many patients referred by other gynecologists and dermatologists who need assistance with the diagnosis and treatment of a variety of vulva problems. Dr. Hall is an active member of the International Society of Vulva and Vaginal Disorders (ISVVD).
A wide spectrum of benign, premalignant, and malignant lesions may involve the vulva. The challenge to the clinician is to differentiate between normal variants, benign findings, and potentially serious disease, and this is not always easy.
Melanomas, basel cell carcinomas and squamous cell carcinomas may occur on the vulva, vaginal opening, anus or buttocks and these areas require systematic exams to complete a total body skin check.
Many dermatologists are hesitant to thoroughly examine the genital area when performing routine skin checks in high risk patients. Dr. Hall offers screening of these hard to see areas with the aid of a colposcope and the use of biopsies when indicated
Vulva Skin Disorders
There are many benign abnormalities of the vulva that may cause severe symptoms such as itching, bleeding, and pain, however many vulva disorders are totally without symptoms. Virtually any skin disorder that occurs in other areas of the body can occur on the vulva.
This includes apthous ulcers (like one gets in the mouth), infections of all types, eczema, contact dermatitis, folliculitis, atrophic vulvitis, polyps, and abscesses.
Lichen sclerosis and lichen simplex chronicus are relatively common diseases that cause a thickening of the vulva skin causing the skin to have a white color.
This chronic inflammation is associated with squamous cell cancers of the vulva and thus frequent evaluation of the vulva skin is indicated. More unusual disorders presenting as vulva lesions include psoriasis, hidradenitis suppurativa,varicose veins, metastatic cancers, lymphoma,bowel disorders and autoimmune disorders.
Many STDs infect the vulva and will present as bumps, ulcers or sores such as genital herpes, condyloma accumunata or molluscum contagiosum. HPV of the vulva and perianal area may lead to vulva or anal cancers if left undetected and untreated.
Clinicians, in general, do not check the vulva in a systematic fashion. At TGM Center, a complete skin check of the vulva, anus, and buttocks requires a separate visit from the annual exam and is indicated in symptomatic patients, patients with HPV infections or patients at high risk for skin cancers.
Vulvodynia is a condition where pressure on the vulva and vaginal opening causes severe pain, resulting in involuntary vaginal muscle contraction, and the inability to have intercourse. If left untreated the pain cycle continues and the problem worsens. It is a process to treat this disorder, and takes active patient participation, but treatment is available and effective.
I had terrible itching and burning of my vulva for 5 years and I had been misdiagnosed by 2 previous OB/GYNs. Dr. Hall knew immediately what the problem was and has successfully treated it for 2 years. I can’t thank her enough. – LH
Contact our office to learn more about our Vulva Dermatology and Vaginal Disorders services or to make an appointment.