O&G Written - Vulval and vaginal disorders

Question 1

Tx of lichen simplex

Answer 1

Avoid irritants - soaps
Emollients
Moderate potency steroid creams
Antihistamines

Question 2

Tx of lichen sclerosus

Answer 2

Ultra potent topical steroid creams

Question 3

Signs/Sx of lichen sclerosus

Answer 3

Severe pruritic - worse at night
Uncontrollable scratching –> bleeding, skin splitting
Discomfort, pain
Dyspareunia

O/E: Pink/white papules coalesce to form parchment-like skin + fissures

Question 4

Complications of lichen sclerosus

Answer 4

Inflammatory adhesions can cause fusion of labia and narrowing of Introits

5% vulval carcinoma

Question 5

Management of vulval intraepithelial neoplasia

Answer 5

Medical: Emollients, mild topical steroids
+ adequate biopsies

Surgical excision = gold standard