Vulvar Edema
Edema is defined as a palpable swelling produced by expansion of the interstitial fluid volume. Vulvar edema is composed of plasma or lymph. Most cases involve the labia minora, which is composed of loose connective tissue, lymphatics, and blood vessels.
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Vulvar Edema Jacob Bornstein
53.1 Introduction Edema is defined as a palpable swelling produced by expansion of the interstitial fluid volume. Vulvar edema is composed of plasma or lymph. Most cases involve the labia minora, which is composed of loose connective tissue, lymphatics, and blood vessels. Edema may affect one or both sides of the vulva [1, 2]. The approach to the management of vulvar edema is by defining the type and the source of the edema present: it could be of either acute or chronic type and primary or secondary. Acute versus chronic vulvar edema: acute edema develops mainly due to allergy and contains plasma. It develops within hours from the contact with the allergen but may appear within minutes or later, after a few days. Chronic edema is the accumulation of lymph in the vulva. The vulvar tissue is firmer in chronic edema than in acute edema. Another way to differentiate between the types is that in acute edema, there is pitting after pressure is applied to the edematous area for at least 5 seconds. Pitting reflects movement of the excess interstitial water in response to pressure. Non-pitting edema suggests chronic- lymphatic edema.
J. Bornstein (*) Department of Obstetrics and Gynecology Galilee Medical Center, Bar-Ilan University Faculty of Medicine, Nahariya, Israel
Primary versus secondary source of vulvar edema: primary edema is defined when it is a fundamental part of a specific disease. Secondary vulvar edema when edema accompanies a specific disease or condition.
53.2 A cute Vulvar Edema: Primary Source Acute allergic angioedema: Vulvar angioedema results from allergy to latex, semen, or vulvovaginal candidiasis. In addition to the vulva, it usually affects the lips, eyelids, or the larynx. Acute allergic angioedema is usually IgE mediated and may deteriorate to anaphylactic shock. The color of the edematous vulva is usually pink or skin colored. It develops within minutes and subsides spontaneously after several hours. Prevention is possible by reducing the use of latex, which may be found in examination gloves and in condoms and contraceptive vaginal diaphragms. Semen allergy may also cause this condition. It develops after exposure to the seminal plasma. It may be confirmed—and prevented—by the use of condoms. In vivo patch and prick tests or blood test (radioallergosorbent test—RAST) are available for confirmation and grading the severity of the specific allergy. Allergy to candidiasis may also cause this type of allergic angioedema. Prevention of both semen and candida allergies should involve graded intravaginal exposure challenge.
© Springer International Publishing AG, part of Springer Nature 2019 J. Bornstein (ed.), Vulvar Disease, https://doi.org/10.1007/978-3-319-61621-6_53
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Allergic contact dermatitis: to topical deodorants, perfumes, detergents, and antibiotics. This condition is not IgE mediated but rather cell- mediated immune reaction. It usually starts only days after the exposure to the allergen. It is red and eczematous. The edema u
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