Terminology
In this chapter we present the contemporary terminologies regarding classification of vulvar lesions that were accepted by the relevant international societies and are being used throughout the book: the clinical terminology of the International Federatio
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Terminology Jacob Bornstein
4.1
Introduction
Over the years, several terminologies and classifications have been developed for vulvar lesions and disorders [1–4], reflecting the input of the various disciplines that take care of vulvar disease. Members of each discipline, i.e., gynecologists, dermatologists, pathologists, and physical therapists, created different sets of terms. Only during recent years, with the establishment of the international societies dealing with vulvar disease, consensus terminologies were established [5–11]. In this chapter we present the contemporary terminologies regarding classification of vulvar lesions that were accepted by the relevant international societies and are being used throughout the book: • The clinical terminology of the International Federation of Cervical Pathology and Colposcopy (IFCPC) which provides basic definitions of the normal and abnormal vulva [9] • The classification of the International Society for the Study of Vulvovaginal Disease (ISSVD) which provides the differential diagnosis of vulvar dermatological disorders [10] • The ISSVD terminology of eczematous and lichenified diseases [8] J. Bornstein (*) Department of Obstetrics and Gynecology Galilee Medical Center, Bar-Ilan University Faculty of Medicine, Nahariya, Israel
These terminologies are pertinent to the diagnostic process of a vulvar lesion. It is recommended to define the pattern of the lesion by using the IFCPC clinical terminology of the vulva and then looking in the ISSVD terminology for further characterization of that pattern. This book is organized according to this recommendation. Hence, the reader can use this book as a guide to diagnosis.
4.2
The IFCPC Terminology of the Vulva [9]
Many women affected by diseases of the vulva are being referred for care to gynecologists working in colposcopy clinics rather than to expert vulva specialists, who are rare in certain regions. However, most colposcopists have not been trained in genital dermatology, but rather in the use of the colposcope to identify pathological cervical transformation zone in women with abnormal cervical Papanicolaou (Pap) smears. Although colposcopists are experienced in diagnosing and treating human papillomavirus (HPV) related diseases and intraepithelial neoplasia of the whole lower genital tract, they usually have no training in benign vulvar disease. This is the reason why the Nomenclature Committee of the International Federation of Colposcopy and Cervical Pathology (IFCPC), headed by the author of this book, created a comprehensive, “total” lower genital tract col-
© Springer International Publishing AG, part of Springer Nature 2019 J. Bornstein (ed.), Vulvar Disease, https://doi.org/10.1007/978-3-319-61621-6_4
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poscopic terminology, not only of cervical and colposcopy findings [12] but also of the vagina and vulva including the anus [9]. However, the introduction of the IFCPC “total” terminology uncovered a debate between dermatologists and colposcopists. The debate was about the quest
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