Vulval Conditions Flashcards
What is lichen sclerosus?
an inflammatory, scarring dermatosis of ano-genital skin
What causes lichen sclerosus?
the aetiology is not fully understood- thought to have an autoimmune component, it is more common in people with other autoimmune conditions
Epidemiology of lichen sclerosus?
peak ages in prepubertal girls and post menopausal women, resolves in children but relapsing in adutls
can occur in males but 6-10x more common in females
Presentation of lichen sclerosus?
symptoms: itch, pain, dyspareunia, constipation (esp in children)
on exam: white papules and plaques (vulval and perineal skin, figure of 8, vagina not involved), ecchymosis (bruising due to inflammation), erosions, fissures, architectural change
Lichen planus vs lichen sclerosus?
similar presentations
planus can affect mucus membranes though so vagina affected and can get discharge (dont get this in sclerosus), planus can also be more systemic and effect mouth and other skin
Complication of lichen sclerosus?
3.5-5% risk of developing vulval SCC
Management of lichen sclerosus?
genital skin care (emollients, avoid tight clothing and irritants), super potent topical steroid with step down regime
Define vulvodynia? What types?
vulval discomfort most often described as a burning pain, occurring in absence of relevant visible findings or a specific, clinically identifiable, neurological disorder
can be generalised or local
provoked or unprovoked
Management of vulvodynia?
info, genital skin care, physio, neuromodulators, for unprovoked, psychosexual intervention
Legality around FGM?
its all illegal
illegal to assist, illegal to perform, illegal to get someone to travel somewhere to get it done
must report
Can FGM be reversed?
no but can do surgery to open up the vagina
