Many tumours are preceded by chronic vulval skin symptoms such as pruritus and irritation, which probably reflect pre-existing skin disorders. Patients complain of the sensation of a painful lump. Abnormal genital tract bleeding or haematuria may occur.
A simple, thorough examination of the external genitalia will identify the majority of tumours. Persistent erythematous areas that are raised or tender should be suspected as invasive disease and a confirmatory full thickness skin biopsy should be performed.
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