Vulvar disorder

Question 1

Causes of vulvar d/o

Answer 1

1. White patches
   Lichen sclerosus
   Lichen simplex
   Vitiligo
2. Erosions/ulcers
   Lichen planus
   HSV/HZV
   Aphthous ulcers
   Chrons disease of vulva
3. Intertrigo
   Candida albicans
   Taenia
   Seborrhic dermatitis
   Psoriasis

Question 2

Lichen sclerosus

Answer 2

1. Chronic inflammatory dermatosis
2. Well defined, white, finely wrinkled plaques (or) reddish patch
   FIGURE OF 8
3. Unknown aetiology
4. Spares vagina
5. Squamous cell CA 2-6% cases

c/f:
Genital pruritis+soreness+white plaques

Question 3

Lichen sclerosus Mx

Answer 3

1. Biopsy
2. Steroid oint long term (Betamethasone)
3. 6montly checkup lifetime to r/o CA

Question 3

*Vulvovaginitis in prepubertal girls

Answer 3

1. 2-8yrs
2. Soreness, redness, itchy, discharge
3. Cause -
   ●Irritation d/t thin mucosa, underwear, handling
   ●FB
   ●Pin worm infestation
   ●Sexual abuse
4. Mx:
   Discharge- Intraoital swab..antibiotics
   Mild- avoid irritants
   FB - bloody discharge, rectal exam

Question 4

Labial agglutinations

Answer 4

1. Adhesions
2. Complication of vulvovaginitis- estrogen cream
3. At birth:
   If urinating properly, no mx. resolves
   If not, Estrogen cream 2-6wks

Question 5

Bartholin cyst

Answer 5

1. Duct obstruction … vulval swelling (painless)
2. Posterior end of labia majora
3. Resolves spontaneously

Question 6

Bartholin abscess

Answer 6

1. If cyst infected -
   red tender, abscess … Bartholin abscess
2. Mx-
   ●Microscopy and culture - E coli/STI (Cl. trachomatis/N.gonorrhoea)
   ●Antibiotics- Flucloxacin/cefalexine
   ●Marsupilisation - recurrent/persistent/large
   ●Sometimes drains spontaneously