Background/Objectives: Vulvar disease leads to significant disease burden and reduced quality of life (QOL). However, vulvar disease-specific instruments to measure QOL are lacking. We developed the Vulvar Quality of Life Index (VQLI) to comprehensively and reproducibly assess symptomatic, psychosexual and physical aspects of vulvar disease. Methods:The VQLI was inferred from a review of the literature regarding QOL of vulvar disease, and responses from a cohort of patients attending specialist clinics. Seven domains and a 15-item questionnaire were developed. This was tested and optimised prior to validation on 248 women, using a control group as a baseline. The VQLI was further tested on 157 women, and the total VQLI score was compared to a self-determined Likert global score on how vulvar disease had impacted their overall health. Results:The VQLI had excellent internal consistency (Cronbach's alpha, 0.93), and test-retest reliability showed that 9/15 questions had a substantial weighted kappa value of 0.5 or above, with good intraclass correlation coefficient (0.88; CI 0.8-0.93). Spearman correlations were consistently positive. Further testing on 157 women demonstrated a significant relationship between the total VQLI score and the effect of vulvar disease on overall health, with high levels of the impact of vulvar disease on overall health associated with high total VQLI score (P < 0.001). Conclusions:The VQLI is a validated, fast and reliable tool to measure the global impact of vulvar disease on QOL and can be used to monitor response to treatment or in a research setting.

Erosive pustular dermatosis of the scalp has particular relevance in Australia, due to its association with actinic damage. Despite its rarity, the recalcitrant nature of erosive pustular dermatosis of the scalp dictates a protracted recovery fraught with relapse and recurrence, posing inherent challenges to successful treatment and complete recovery. In Australia, erosive pustular dermatosis of the scalp is prevalent in the elderly, who are negatively affected due to the condition. We propose a management outline to aid clinical practice, to improve the quality of life in the elderly, whilst providing insight into the current understanding and treatment of erosive pustular dermatosis of the scalp.

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