Clinical examination and colposcopically directed biopsy are used to diagnose the cause of diffuse vulval abnormality. Excision biopsy is carried out for well-circumscribed masses or naevi. Vulval tumours are usually squamous cell carcinomas (80% of total) but malignant melanoma, basal cell carcinoma and Paget's disease also occur on the vulval skin. Bartholin's glands or glands in the urethra may give rise to adenocarcinoma, and there are other rare forms of cancer arising within intraepithelial structures.
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