Management of vulval itching caused by benign vulval dermatoses TOG 2017 Flashcards
What is this?
How to manage?
Contact dermatitis affecting female genitalia
Consider patch testing if allergic contact dermatitis suspected
Moderate (clobestone) or potentent steroids, emollients, avoid irritant - GP or derm to manage
What is this?
How to treat
Psoriasis effecting female genitalia
Exam rest of body, Bx if unsure
Moderate potency steroids, consider secondary infection, steroids - refer to dermatology
Definition nodule, papule and plaque
Nodule - large palpable lesion >0.5cm
Papule - palpable Lesion <0.5cm
Plaque - flat lesion >0.5cm
When is vulval biopsy indicated?
1) all areas of vulval melanosis and new or changing pigmented lesions; 2) persistently eroded areas; 3) indurated and suspicious ulcerated areas; or
4) when there is poor response to treatment following the initial diagnosis.
What is used to performed biopsy?
4mm Keyes punch biopsy
Flow diagram for managing vulval itch
What is this?
Risk of malignant transformation
Treatment?
Lichen sclerosus
5%
Topical steroids and emollients
What is this?
Erosive Lichen Planus - erosopms at introtus
2 types of lichen planus
Classical - well demarcated plaques with outlaying lacy white lines - topical steroids and emolliebnts
Non classical - erosions, Wickham striae, losss of anatomy - difficult to treat
How does lichen simplex appear?
Lichenification of the skin with erosions from chronic scratching
No loss of anatomy but may give ‘leathery look’
Steroids and emollients
Can become secondary infections
