Oral and vulval disease: prevalence, associations, and management recommendations for the oral medicine clinician

Objective

The oral cavity is a common site for mucosal conditions which may be confined to the mouth, or may manifest as mucocutaneous involvement at other sites, including the anogenital region. This retrospective analysis aimed to assess the appropriateness of oral medicine referrals to a specialized vulval clinic and review the prevalence of oral disease associated with vulval involvement of the same condition.

Study Design

One hundred thirty-six patients referred from oral medicine to the vulval service at Guy's Hospital were analyzed. Retrospective data collated included: reason(s) for referral, onset of oral and genital symptoms, oral diagnosis, vulval diagnosis, correlation between the oral and vulval diagnosis, and discharge at first appointment.

Results

Forty-nine percent (n = 67) of the patients had oral and vulval manifestations of the same disease. The majority of these patients (n = 63) were diagnosed with vulval lichen planus, of whom 61 had concomitant oral lichen planus involvement (97%). Other associated oral and vulval diseases included aphthous ulceration, Behçet's disease, dryness secondary to Sjögren's disease, Crohn's disease, and mucous membrane pemphigoid. The remaining 51% (n = 69) of the patients presented with independent vulval conditions unrelated to their oral disease.

Conclusion

Clinicians should recognize the association between genital symptoms and oral disease and refer to specialist allied services, as appropriate.