Vulval pain and pruritus are symptoms associated with benign or malignant diseases. The paucity of information regarding aetiological factors confounds a logical approach to successful therapeutic and preventative strategies. Research continues to address the possible relationship between human papillomavirus and benign, premalignant and malignant vulval conditions. Although present in many conditions, oncogenesis caused by human papillomavirus has yet to be proven as a cause of vulvar premalignant and malignant diseases. The natural history and management of these and benign disorders have been reported during the period of review. Some of the new findings may alter present concepts and practices.