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Vulvar skin Disorder

PB 224 - Vulvar skin disorders

QuestionAnswer
Non-scarring condition with intense pruritis with itching and rubbing especially at night Lichen simplex chronicus
Scarring condition with unknown etiology found in prepubescent and post menopausal women Lichen sclerosus
Scarring condition with unknown etiology found mainly in post menopausal women and also effecting other mucosal surfaces Lichen planus
Management of contact dermatitis Prevention and use of local steroid ointments, antihistamines, and occasionally anti-depressants
Management of lichen simplex chronicus Prevention and higher dose local steroid ointments
Diagnosis of lichen simplex chronicus clinical - plaques of erythema with scaling
Risk of underlying vulvar squamous cell carcinoma with lichen sclerosus 5%
Diagnosis of lichen sclerosus Clinical + biopsy - thin, white, wrinkled skin in figure 8 pattern sparing vaginal mucosa
Management of lichen sclerosus high potency topical corticosteroids (clobetasol)
Management of lichen sclerosus resistant to first line therapy intralesional steroid injections and topical calcineurin inhibitors.
Diagnosis of lichen planus Clinical + biopsy - fern-like white or dark pink poorly demarcated lesions with +/- erosive patches often involving posterior vestibule and vaginal mucosa
Management of lichen planus high potency topical corticosteroids (clobetasol) however often with poor control
Created by: C.Beienburg
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