Vulval Itch

Question 1

Causes of Vulval Itch in Puberty and before menopause

Answer 1

irritant dermatitis
lichen simplex
candida
psoriasis
lichen sclerosus 
atrophic vulvo vaginitis 
allergic contact dermatitis

Question 2

Causes of Vulval Itch in post menopausal woman

Answer 2

irritant dermatitis 
lichen simplex 
atrophic vulvo vaginal vaginitis 
lichen sclerosis 
psoriasis 
candida 
allergic contact dermatitis

Question 3

Lichen Sclerosus
1/  What is it 
2/ presentation 
3/ extravulval sites 
4/ complications 

Tx –> steroids

Answer 3

1/ assoc’d with autoimmune diseases e.g. thyroid, pernicious anemia.

2/ white appearance around vulva, itchy +++

Can be asymptomatic

3/ thighs, buttocks, under breasts, shoulders, armpits, can occur in men as well

4/ Loss of anatomy (clitoris buried, labia majora shrinks, intraoital stenosis)

vulval cancer 5%

Question 4

Lichen Planus
1/  What is it 
2/ presentation 
3/ extravulval sites 
4/ complications 

Tx –> may resolve, but tx with steroids, tacrolimus

Answer 4

1/ lacy white appearance, painless
2/ can present with painful vaginitis, shallow ulcers
3/ mucous, cutaneous, nail,
4/ vaginal stenosis, vulval cancer

Question 5

Lichen Simplex
1/ What is it
2/ TX

Answer 5

1 / localised area of lichenified eczema, dermatitis caused by repetitive scratching + rubbing
2/ steroids for 4-6/52