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The article discusses the management of vulvovaginal diseases in the inpatient hospital setting. It describes inflammatory conditions including pustular psoriasis of pregnancy, hidradenitis suppurativa and genital herpes and their treatment. Information is provided on ulcerative conditions and their treatment including acute vulvar aphthous ulcers, pyoderma gangrenosum and cutaneous Crohn disease.

Lipids synthesized on the skin are critical to the antimicrobial barrier. Skin lipids also facilitate survival of lipophilic skin commensals in an otherwise dry and acidic ecological landscape. Thus, skin‐specific stearoyl‐coenzyme A desaturase 1 knockout mice (Scd1ΔK14) with sebocyte atrophy and decreased synthesis of monounsaturated fatty acids, triglycerides and wax diesters have dry, inflamed skin. Here, we used 16S rRNA (V1‐V2 and V1‐V9) and internal transcribed spacer 1 (ITS1) amplicon sequencing to compare bacterial and fungal skin microbiomes between Scd1ΔK14 mice and wildtype control mice (Scd1fl/fl) in a barrier facility. Saprophytic bacteria including Sporosarcina spp. and Staphylococcus lentus and saprophytic fungi including Alternaria infectoria were found in higher relative abundance in the Scd1ΔK14 group (ANCOM). Analysis of community diversity (Shannon index) revealed greater fungal alpha diversity in the Scd1ΔK14 group (p = 0.009, Kruskal–Wallis). Principal coordinates analysis (Bray–Curtis dissimilarity) showed that both bacterial (p = 0.002, PERMANOVA) and fungal communities (p = 0.006, PERMANOVA) of the Scd1ΔK14 group were unique from the wildtype group. Altogether, these results suggest that sebaceous gland‐derived lipids normally restrict the skin microbiome, and in the absence of these lipids, a greater diversity of opportunistic organisms are able to colonize the surface of skin. [ABSTRACT FROM AUTHOR]