The Authors take up a proposal made in 1976 by the International Society for the Study of Vulvar Dystrophies (I.S.S.V.D.) and, with the help of clinical cases, consider the problem of vulvar dystrophic pathology from the point of view of clinico-histologic classification and terminology. The schematic analysis of the etiopathogenetic hypothesis (still uncertain) and the consequent not infrequent failures of clinical therapy suggest to consider indications for surgical treatment. This is particularly true for young patients because in these cases the treatment must also aim at an acceptable aesthetic result and the recovery of satisfactory sexual function. To show the possibility of meeting these requirements, the Authors report the results of plastic surgical treatment on a 28 year patient suffering from chronic vulvar dystrophy after many failures of medical therapy.