Vulval Itch Flashcards
mechanisms of vulval itch causes
infective
VIN
menopause
skin conditions
infective causes of vulval itch
candidiasis
trichomoniasis
pubic lice
scabies
how can menopause cause vulval itch?
atrophic vulvovaginitis
skin conditions that can cause vulval itch
dermatitis psoriasis lichen sclerosis lichen planus lichen simplex
what is lichen sclerosis?
inflammatory dermatosis of the ano-genital skin
peak incidence of lichen sclerosis
prepubertal girls
postmenopausal women
presentation of lichen sclerosis
itch, usually at night pain dyspareunia constipation absence of red flags
what are red flags in vulval itch?
ulcer
lump
weight loss
examination signs of lichen sclerosis
white plaques figure of 8 anal involvement vagina not involved ecchymosis architectural change (loss of labia minora, narrowed introitus) erosions fissures
risks in lichen sclerosis
SCC (chronic inflammation)
VIN
risk factor for lichen sclerosis
smoking
management of lichen sclerosis
skin care
emollients
super potent topical steroids
skin care in lichen sclerosis
wash once daily with soap substitute
avoid tight clothing
avoid irritants
peak incidence of lichen planus
50-60s
lichen planus associations
AI itch pain dyspareunia DISCHARGE oral, nails, hair inside vagina can be affected
presentation of atrophic vulvovaginitis
itch
soreness
dryness
dyspareunia
examination findings in atrophic vulvovaginitis
thin discharge urethral caruncle atrophy of labia rugae loss pallor petechial haemorrhages narrowed introitus
management of atrophic vulvovaginitis
vaginal oestrogen e.g. ovestin (cream), estring (3 month ring in vagina) and vagirus (nightly)
complication of atrophic vulvovaginitis
secondary vaginismus
management of vaginismus
perineal massage
lubricants
vibrator
