Objectives: To evaluate the clinical and dermoscopic features of different vulvar diseases.
To show our experience during the everyday practice referring the dermoscopic use for different condition of vulva and genital area in females.

Introduction: During everyday practice, we perform different procedures to rejuvenate and treat different conditions of female genital area. Any aesthetic rejuvenation or treatment protocol must first begin with an accurate diagnosis of the various diseases affecting this area. Dermoscopic knowledge are becoming a must nut just for dermatologist but either for every doctor.

Materials / method: Female patients diagnosed and treated in our clinic for aesthetic rejuvenation or skin diseases of the genital area during the years 2020-2023 were included in the presentation. A total of 125 patients were diagnosed and treated for vulvar and genital disorders. We divided the manifestations into five groups based on distinct clinical and dermoscopic features: inflammatory diseases, vascular diseases, tumors, infectious diseases, and others.

Results: In our group of patients ( 125 patients) the most common disorder of the genital area was vulvar melanosis followed by inflammatory diseases (psoriasis and lichen). On dermoscopy, vulvar melanosis presented as a single or several patches with a "parallel-line pattern" and a consistent brown color. Vulvar psoriasis showed dotted vessels spaced regularly inside a well-defined erythematous patch on dermoscopy, while short linear vessels and structureless white areas were characteristic of most genital lichen cases.

Conclusion: Physicians who undertake aesthetic procedures on the genital region must have a thorough understanding of the clinic and dermoscopy characteristics of various disorders that impact this area.

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Objectives: The injection of Hyaluronic Acid on the genital sphere represents an effective and simple and painless treatment. This procedure is practiced in the medical office. No need to go on surgical room.
It is an immediately effective treatment. It must be repeated every year.

Introduction: After menopause, after treatment for breast cancer, sometimes even in young women (more and more often), sometimes after delivery, or a painful episiotomy,
The estrogen deprivation induce vulvovaginal atrophy, with vaginal dryness and dyspareunia.

Materials / method: METHODS
After local anesthesia, injection of 1 seringue of HA on the vestibule and the lower third of the vagina.
Immediately effective, this treatment needs to be repeated approximately once a year.
NO MORE TABOO
If the taboo is removed
the hyaluronic acid injection is quickly effective.

Results: RESULTS
The majority of patients immediately feel better intimate comfort and 80% of couples find harmonious sexual activity after ten days.

Conclusion: GOAL
Improving comfort during intercourse and vaginal dryness
Can improve the quality of life of patients in general, and in particular those treated for breast cancer.

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Objectives: Our systematic review highlights the BoNT administration for vulvar and vaginal pain. Positive outcomes are available in literature and safety profile and effectiveness of BoNT are provided, although a clear standardization is needed for practical guidelines. Future perspectives should address reproducible protocols for BoNT administration in relieving women from vulvodynia, vaginismus and chronic pelvic pain.

Introduction: Botulinum toxin (BoNT) administration has been proposed in the gynecologic field for pelvic, vulvar and vaginal disorders. On this regard, we aimed assessing the therapeutic effectiveness and safety of BoNT usage in the treatment of vaginal, vulvar and pelvic pain disorders.

Materials / method: We searched for all the original articles without date restriction until 31.12.2021. We included all the original articles which administered botulinum toxin in the vulva or vagina of women suffering from vaginismus, dyspareunia, and chronic pelvic pain. Only English language studies and those performed in humans were eligible. We excluded all case reports and pilot study from the qualitative analysis, although we accurately evaluated them. 22 original studies were finally included in the systematic review.

Results: Botulinum toxin injection was found to be effective in improving vulvar and vaginal dyspareunia, vaginismus, and chronic pelvic pain. No irreversible side effects were detected. Major side effects reported were transient urinary or fecal incontinence, constipation and rectal pain. The risk of bias assessment proved original articles to be of medium quality. No metanalysis could have been performed since lack of congruency in the definition of pathology and methods of botulinum toxin administration.

Conclusion: Data extraction pointed out different endpoints and different methods of analysis. Studies focus on different types of participants and use various techniques and timing. According to the best evidence available, different techniques provide evidence about positive outcomes, with the need for a standardized protocol.

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