Vulvar Disorders Flashcards
Lichen sclerosis – usual time of onset? Location? Symptoms?
Post-menopause; anogenital region; itching worse at night
Vulva consists of?
Mons pubis, labia majora/minora, clitoris, vestibule, urethra, vagina
Differential for lichen sclerosis?
Lichen planus, psoriasis, vulvar intraepithelial neoplasm, vitiligo
Physical exam findings in lichen sclerosis?
- Figure-8 around vulva/anus
- Cigarette paper vulva – crinkled, fragile, thinned
- Tears from scratching/intercourse leading to scarring/narrowing of interoitus
- Fusion of labia minora, burying clitoris
Advice on how to alleviate symptoms of lichen sclerosis?
- Avoiding soaps/bubble
- Cessation of scratching
- All cotton, white underwear
Lichen sclerosis treatment?
- Clobetasol (Potent steroid) for initial relief
2. Weaker steroids
Location of Bartholin’s glands? Treatment of abscess?
Five-and 7 o’clock locations on the labia majora
Incision and placement of small balloon catheter or marsupialization (surgical fixation system ball diverted against mucosa of vulva)
Organisms in Bartholin’s gland infections? Biopsy if?
Polymicrobial; women over 40 (associated with cancer)
Symptoms of vulvar cancer? Types?
No symptoms, itching
Squamous cell carcinoma > melanoma, basal cell carcinoma
postmenopausal women has pain with intercourse – diagnosis? Pathophys? Tx?
Postmenopausal vulvar atrophy
Due to decreased estrogen; topical estrogen
Postmenopausal women complains of intense itching around the vagina and anus which makes intercourse and defecating painful – diagnosis?
Lichen sclerosis
Patient with poorly controlled diabetes reports tears on vagina and burning upon urination – diagnosis?
Excoriations from Candida vaginitis
Postmenopausal women presents with 10 year history of vaginal itching and bump near clitoris – diagnosis?
Lichen sclerosis that has become vulvar carcinoma
Postmenopausal woman complaining of itching on her vagina and lesions on her elbows?
Psoriasis
