Vulva Flashcards
Vulval itch differentials?
- Candidiasis
- trichomoniasis
- pubic lice
- scabies
- dermatitis
- psoriasis
- lichen sclerosis
Explain lichen sclerosis?
- inflammatory, scarring, dermatosis
- autoimmune link
- hypopigmentation
- architeural changes
Symptoms of vulval lichen sclerosis?
- itch worse at night
- pain
- constipation (children)
- no change to discharge
- hypopigmentation
- figure of eight
- architectural changes
Lichen sclerosis on the vulva has a risk of what?
- scc
Treatment of lichen sclerosis?
- gentle skin wash
- emoilents
- high dose topical steroids (clobetasol propionate)
Believed to be lichen sclerosis but discharge changes?
- lichen planus
Explain atrophic vaginitis?
- associated with menopause
- atrophy of labia and vaginal opening
Symptoms of atrophic vaginitis?
- itch
- dryness
- atrophy
- red membrane
Treatment of atrophic vaginitis?
- vaginal oestrogen (cream or ring)
- lubrication
- massage
- vibrators
What is vulvodynia?
- vulval discomfort
- diagnosis of exclusion
Symptoms of vulvodynia
- pain
- burning
- blocked feeling during sex
- cotton wool elicits pain
2 categories of vulvodynia?
- localised/provoked
- generalised / unprovoked
Treatment for provoked localised vulvodynia?
- lidocaine ointment
- physio
Treatment for generalised unprovoked vulvodynia?
- tricyclics
- gabapentin
Presentation of FGM?
- Outer labia fused
- small introitus
Short term complications of FGM?
- Haemorrhage
- urinary retention
- genital swelling
- infection
- death
Long term consequences of FGM?
- UTIS
- Stricture
- dyspareunia
- obstetric complications
Management of FGM?
- Support
- risk assess, report?
- surgery (de-infibulation)
What surgery can be offered to FGM patients?
- de infibulation
Commonest type of vulval cancer?
- squamous cell carinoma
- if on bartholins gland = adenocarcinoma
Treatment of vulval cancer?
- wide local exicision
- chemotherapy
