vulval disorders

Question 1

How does luchen scleosis present and what does it increase risk of?

Answer 1

Usually in post menopausal women and causes thinning of the epidermis of the vulva and vagina
This causes a patchment like appearance
There is a small risk of developing squamous cell carcinoma

Question 2

What is the management of lichen sclerosis?

Answer 2

Cant be cured but can be managed with potent topical steroids
This reduces risk of malignancy
Used for 4 weeks then gradually reduced, can be started again in flares
Should be used in conjunction with emmolients

Question 3

What type is the most common vulval cancer?

Answer 3

They are rare compared to other gynae cancers, most commonly SCCs

Question 4

What are the risk factors for developing vulval scc?

Answer 4

HPV is a major risk factor

Vulval intraepithelial neoplasia is a premalignant condition affecting the squamous epithelium

Question 5

What is the management of vulval cancer?

Answer 5

Biopsy of the lesion
Sentinal node biopsy (inguinal lymph nodes)
Further imaging for staging (CT abdo pelvis)
Managed:
-Wide local excision
-Groin lymph node dissection
-Chemotherapy
-Radiotherapy