Terrinoni Matteo, Golia D'Augè Tullio, D'Oria Ottavia, Palisciano Michele, Adinolfi Federica, Rossetti Dario, Di Renzo Gian Carlo, Giannini Andrea
Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy.
Department of Obstetrics and Gynecology, "Alto Tevere" Hospital of Città di Castello, USL Umbria 1, 06127 Perugia, Italy.
Life (Basel). 2025 Aug 28;15(9):1365. doi: 10.3390/life15091365.
Vulvar viral infections such as condyloma acuminata, genital herpes, molluscum contagiosum, and Lipschütz ulcers span both sexually and non-sexually transmitted diseases and affect patients across all age groups. Lesions may present as papules, verrucous growths, or painful ulcers, often causing functional impairment and significant psychosocial distress. A multidisciplinary strategy that integrates epidemiology, precise diagnostics, individualized therapy, and psychological support is essential to optimize outcomes. We performed a structured literature search in PubMed, Scopus, and Web of Science using terms "vulvar viral infection," "HPV," "HSV," "molluscum contagiosum," and "Lipschütz ulcers." International guidelines from the UK, Europe, and Australia were reviewed, alongside reference lists of key articles. Particular attention was given to paradoxical presentations, pediatric considerations, and cost-effectiveness analyses. HPV vaccination programs have markedly reduced anogenital warts, while early PCR/NAAT for HSV accelerates targeted antiviral therapy. First-line treatments like oral acyclovir/famciclovir for HSV and topical imiquimod or podophyllotoxin (±cryotherapy) for HPV are supported by adjunctive measures for self-limiting conditions. Host factors (hormonal cycles, immune status) and local irritants modulate recurrence risk, informing anticipatory suppressive regimens and barrier-reinforcing care. Validated patient-reported outcome measures (VPAQ, DLQI, FSFI) capture pain, sexual function, and quality-of-life impacts. Health-economic evaluations underscore the long-term value of rapid diagnostics and broad vaccination. Personalized, multidisciplinary management that combines prevention, precision diagnostics, tailored therapy, psychosocial support, and economic considerations offers the greatest promise for improving clinical and quality-of-life outcomes in patients with vulvar viral infections. We aim to outline best practices for the diagnosis and management of common vulvar viral infections, providing practical guidance for clinicians to improve recognition and therapeutic decision-making.
外阴病毒感染，如尖锐湿疣、生殖器疱疹、传染性软疣和利普许茨溃疡，既包括性传播疾病，也包括非性传播疾病，影响所有年龄组的患者。病变可能表现为丘疹、疣状生长或疼痛性溃疡，常导致功能障碍和严重的心理社会困扰。整合流行病学、精确诊断、个体化治疗和心理支持的多学科策略对于优化治疗效果至关重要。我们在PubMed、Scopus和Web of Science中进行了结构化文献检索，使用了“外阴病毒感染”、“人乳头瘤病毒”、“单纯疱疹病毒”、“传染性软疣”和“利普许茨溃疡”等术语。我们查阅了英国、欧洲和澳大利亚的国际指南以及关键文章的参考文献列表。特别关注了矛盾的表现、儿科注意事项和成本效益分析。人乳头瘤病毒疫苗接种计划显著减少了肛门生殖器疣，而早期单纯疱疹病毒的聚合酶链反应/核酸扩增检测可加速靶向抗病毒治疗。单纯疱疹病毒的一线治疗药物如口服阿昔洛韦/泛昔洛韦，以及人乳头瘤病毒的一线治疗药物如局部使用咪喹莫特或鬼臼毒素（±冷冻疗法），都有针对自限性疾病的辅助措施支持。宿主因素（激素周期、免疫状态）和局部刺激物会调节复发风险，为预期的抑制方案和加强屏障护理提供依据。经过验证的患者报告结局指标（VPAQ、DLQI、FSFI）可反映疼痛、性功能和生活质量的影响。健康经济评估强调了快速诊断和广泛接种疫苗的长期价值。结合预防、精确诊断、个性化治疗、心理社会支持和经济考虑的个性化多学科管理，为改善外阴病毒感染患者的临床和生活质量结局提供了最大的希望。我们旨在概述常见外阴病毒感染的诊断和管理的最佳实践，为临床医生提供实用指导，以提高识别能力和治疗决策能力。
