A cross-sectional study of the vulval dermatology clinic population over a 4-year period and development of a national vulval disease database.

Abstract

Background: Vulval disease significantly impacts quality of life but is historically under-researched. The epidemiology and aetiology of many vulval conditions is unclear. Data to optimise patient care are lacking.

Objectives: To describe the population attending a specialist vulval dermatology clinic and achieve consensus amongst vulval experts on data items to be collected for a future national vulval database.

Methods: This descriptive cross-sectional study analysed data that was prospectively collected during clinical contact with consecutive new patients at a vulval dermatology clinic over 4 years.A two-stage electronic-Delphi survey was performed with British vulval experts. Consensus was defined as ≥75% agreement on items for inclusion.

Results: The database included 424 (including 29 paediatric) patients. Most patients were White British (71%), with a significant Asian population (13%). Long symptom duration (9.5% > 10 years) and multiple diagnoses, up to 4, were common. Exploratory associations were identified between irritant contact dermatitis and urinary and faecal incontinence, frequent vulval washing and lichen simplex, urinary incontinence and lichen sclerosus and a negative association between candidiasis and age.Following two rounds of the electronic-Delphi survey, consensus was achieved for 18 items that 28 participants agreed were important for a future database.

Conclusions: We report disease incidence, patient pathways, outcome measures and potential associations. Though not generalisable, this large UK-based study could inform future projects to improve patient care and support ongoing research, such as a national vulval disease database, for which we also achieve expert consensus on the most valuable items to include.