Vulval Ulcers

Availability

North South North West Statewide

Pre-referral work-up

History

Patients may be referred for chronic vulva irritation, vulva abscesses, and vulva ulceration.

Vulvar Cancer; see Gynaecological-Oncology Clinic.

All referrals should comply with referral standards and include in particular:

  • History of condition, including itch, discharge,
  • Menopausal status
  • Obstetric and gynaecological history, and sexual history
  • Current and past treatments and efficacy of same
  • Good description of the lesion – pigmented, bleeding, ulcerated
  • Presence or absence of chronic diseases such as Crohn's

Tests

  • Swab – m/c/s if indicated
  • STD screen including swab of ulcer for herpes, serology for syphilis
  • Biopsy of chronic lesions – if within skill set of GP
  • Pap smear
  • Exclude UTI

Interim/GP management

To refer a patient with this condition, please see the Gynaecology clinic page for the full referral process and templates.

Moisturisers - bland emollients such as Zinc/Castor oil cream.

Treat Herpes Simplex with appropriate anti-virals. Hospitalisation may be needed if unable to urinate

For more information please see the Tasmanian Health Pathways website.

Urgent / category 1

Ulcers in menopausal patients

Ulcers that haven't healed with short course of emollients or mild steroid cream

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340 Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:
Routine:

Will be seen in turn.