voyeurismThe observation, on a regu-
lar basis, of unsuspecting people who
may be naked, getting undressed, or
engaged in sexual activity, in order to
achieve sexual arousal.
VSDThe abbreviation for ventricular
septal defect.
vulvaThe external part of the female
genitalia, comprising the clitorisand 2
pairs of skin folds called labia.
The most common symptom affecting
the vulva is vulval itching. Various skin
disorders, such as dermatitis, may affect
the vulva. Specific vulval conditions
include genital warts, vulvitis, vulvo-
vaginitis, and cancer (vulva, cancer of).
vulva, cancer ofA rare disorder that
most commonly affects postmenopausal
women. Cancer of the vulva may be pre-
ceded by vulval itching, but in many
cases the first symptom is a lump or
painful ulcer on the vulva.
A diagnosis of vulval cancer is made
by biopsy. Treatment is by surgical
removal of the affected area. The out-
look depends on how soon the cancer is
diagnosed and treated.
vulval itchingIrritation of the vulva.
Most commonly, vulval itching is due to
an allergic reaction to chemicals in
spermicidal or hygiene products. Itching
is also common after the menopause,
when it is due to low levels of oestrogen.
In addition, vulval itching may be
caused by a vaginal discharge due to
infection (see vaginitis) or by vulval skin
changes (see vulvitis).
Treatment may be with antibioticsor
hormones, depending on the cause.
vulvitisInflammation of the vulva.
Infections that may cause vulvitis are
candidiasis, genital herpes (see herpes,
genital), and warts (see warts, genital).
Infestations with pubic liceor scabies
are other possible causes. Vulvitis may
also occur as a result of changes in the
vulval skin. These changes tend to affect
women after the menopause, although
there is no apparent trigger. They may
take the form of red or white patches
and/or thickened or thinned areas that
may be inflamed. Other possible causes
of vulvitis include allergic reactions to
hygiene products, excessive vaginal dis-
charge, or urinary incontinence.Treatment depends on the cause. A
combination of drugs applied to the vulva
and good hygiene is usually recom-
mended. A biopsymay be taken, if there
are skin changes, to exclude the slight
possibility of vulval cancer. (See also
vulvovaginitis; vaginitis.)
vulvovaginitisInflammation of the vulva
and vagina. Vulvovaginitis is often pro-
voked as a result of the infections
candidiasisor trichomoniasis. (See also
vaginitis; vulvitis.)VOYEURISM VULVOVAGINITISV