Vulval disorders Flashcards

1
Q

List 4 symptoms of vulval dermatitis

A

dermatitis - DIE Pain

D - discharge
I - itch
E - erythema
Pain

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2
Q

List 4 signs of vulval dermatitis

A

Dermatitis - DEE DIES

Dry skin
Erosions
Erythema

Dry skin
Itch
Erythema
Symmetrical

DEE = signs
DIES = symptoms
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3
Q

List 3 symptoms of vulval psoriasis

A

Itchy ASS

I - itch
A - arthritis
S - Scaly Skin

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4
Q

list 2 signs of vulval psoriasis

A
  • red, scaly, well demarcated patches

- asymmetrical patches

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5
Q

List 4 symptoms of lichen sclerosis

A
Itch
Dry skin
Dyspaerunia
pain
May be asymptomatic
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6
Q

List 6 signs of lichen sclerosis

A
  • loss of vulval architecture
  • pale vulva/anogenital area
  • figure of 8 sign - pale skin around Introits and anus
  • hair loss
  • spares vagina
  • fusion of labia
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7
Q

List 4 signs of lichen planus

A

The vagina P’s

May involve vagina
Purple
Papules or plaques
Appears inflamed or sore

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8
Q

List 6 contributing factors to vulval dermatitis

A
  • sweat
  • recurrent candidiasis
  • synthetic underwear
  • douching
  • use of chemical on vulva
  • laundry detergents
  • spermacides
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9
Q

List 4 macroscopic features that are consistent with lichen sclerosis

A

PAVLOva

P - pale skin around anus/introitus
A - asymmetry
V - vaginal stenosis
L - labial fusion/Loss of architecture
O - obliteration of clitoral hood
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10
Q

What advice would you give someone about lichen sclerosis as a condition?

A
  • autoimmune condition
  • causes chronic inflammation of the vulva
  • associated with an increased risk of vulval cancer
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11
Q

What management options are available for lichen sclerosis?

A
  • conservative - cotton underwear, sleep without underwear, avoid vulval irritants/douching
  • medical - treat with potent steroids lifelong
  • surgical - occasionally labioplasty is required for restoration of anatomy and for sexual/urinary function
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12
Q

List 5 conditions that present with vulval itch and rash?

A
Vulval dermatitis
Lichen sclerosis
Lichen planus
VIN
lichen simplex chronicus
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13
Q

Describe the medical management of vulval dermatitis

A
  • avoiding causative agents is first line
  • cream/emollient
  • Anti-histamine
  • consider course of low potency steroid
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14
Q

What is the differential diagnosis for vulval itch?

A
THIINN
Trauma 
hormonal
infection
inflammatory
Neoplastic 
neurological
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15
Q

What can cause traumatic vaginal itch

A
  • obstetric trauma

- FGM

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16
Q

What are the causes of infective vaginal itch?

A
  • candidiasis

- HSV

17
Q

What are the causes of inflammatory vaginal itch?

A
  • eczema
  • contact dermatitis
  • psoriasis
  • lichen simplex chronicus
  • lichen planus
  • lichen scelorosis
  • desquamative inflammatory vaginitis
18
Q

What are the causes of neoplastic vaginal itch?

A

VIN/VAIN

Extra-mammary pagets disease

19
Q

What are the causes of neurological vaginal itch?

A

post-herpetic neuralgia

nerve injury

20
Q

What are the hormonal causes of vaginal itch?

A

atrophy

21
Q

What are 3 characteristics that can help you differentiate Lichen sclerosis from lichen planus?

A
  • Lichen sclerosis occurs on the vulva only, whereas LP affects vagina also
  • LS is white and is not primarily erosive, whereas LP is red/erythematous and primary erosive
  • LS occurs in children while LP rarely occurs in childhood
  • LS is associated with malignancy while LP only rarely associated with malignancy