Vulval Conditions Flashcards
what is lichen sclerosus?
an inflammatory, scaring dermatosis of the ano-genital skin
who is most commonly affected by lichen sclerosus?
women
prepubertal or postmenopausal
what diseases is lichen sclerosus linked with?
autoimmune conditions
what is the clinical course of lichen sclerosus like in children?
can resolve
what is the clinical course of lichen sclerosus like in adults?
relapsing
what are the symptoms of lichen sclerosus?
itch
pain
dyspareunia
constipation (especially in children)
what is common in the PMH of someone with lichen sclerosus?
other skin conditions
autoimmune diseases
what is there a possible risk of developing in lichen sclerosus?
SCC
what is involved in the management of lichen sclerosus?
genital skin care advice
vert potent topical steroid
what topical steroid is given for lichen sclerosus and how?
dermovate
0.5 finger tip unit daily for 12 weeks
what is another name for dermovate?
clobetasol propinate 0.05%
what is the management of genitourinary syndrome of the menopause?
vaginal oestrogen
how can vaginal oestrogen be administered?
ovestin
estring
vagirux
what is vulvodynia?
vulval discomfort occurring in the absence of relevant clinical findings of a neurological disorder
how is localised, provoked vulvodynia managed?
lidocaine 5% ointment
vaginal trainers
physiotherapy
how is unprovoked vulvodynia managed?
tricyclics
gabapentin/pregabalin
how is vulval cancer investigated?
biopsy
USS groin
MRI
how can vulval cancer lesions be managed if they are confined to the vulva?
wide local excision
how are vulval cancer lesions managed if confined to the pelvis but with more than 1mm of invasion?
WLE/BGND
how are vulval cancer lesions without obvious groin node involvement managed?
chemoradiotherapy
what is the most common type of vulval cancer?
SCC
what is the most common site of vulval adenocarcinoma?
bartholins gland
how long are patients with vulval cancer followed up for after treatment?
five years
what are possible precursors for vulval cancer?
young women - HPV
older women - lichen sclerosus
