A myriad of diseases that affect the skin can involve the perigenital regions, including vulvar skin and mucosa. Some processes may mimic neoplastic lesions, while others may increase risk of developing neoplasia or may indicate a risk for subsequent disease/malignancy. Many processes carry substantial morbidity, affecting the patient’s quality of life. Familiarity with the histologic spectrum of inflammatory processes involving the vulva will allow for appropriate treatment and further triage/screening of patients. Entities covered in this chapter include contact dermatitis, psoriasis, lichen simplex chronicus, lichen sclerosus, lichen planus, blistering diseases, hidradenitis, and other inflammatory diseases. This chapter provides a framework by which to recognize many of these inflammatory dermatoses, discusses the clinical presentations, associated conditions, histopathologic findings and differential diagnoses, and suggests practical ways to handle biopsies provided with minimal clinical information.