46 years old, had been complaining of papular vulvar lesions occasionally and slightly pruritic, which bled upon friction with clothing, for three months. She complained of chronic constipation and sporadic abdominal colic pain. She denied having hemorrhoidal varices. She has history of 3 pregnancies, the last 20 years ago, with 2 births; the first, by vaginal delivery and the second, by cesarean section, and an abortion. Please advice
?? LICHEN SCLEROSIS/VULVOVAGINITIS RULE OUT DIABETES PAP SMEAR, VEGINAL SWAB AND URINE FOR C/S,TFT CAP DOXYCYCLINE BD TAB FLUCONAZOLE 200 TAB ALBENDA+IVERMACT OINT. CIPROLAR-FC FOR LA ANTIHISTAMINE ANTIOXIDANTS PERSONAL HYGIENE
Linchen Sclerosis. A chronic condition that causes thin, white patches of skin, usually in the genital area. This condition occurs primarily in girls who haven't started menstruating and in postmenopausal women. Lichen sclerosus is thought to be related to genetics, immune disorders, trauma or infection. Irritants such as soap, detergents, shower gels, bubble baths can aggravate lichen sclerosus, so using these irritants should be avoided. Friction or damage to the skin can make it worse so overzealous washing and drying the vaginal or anal area should be avoided.
Seems to be Lichen Sclerosis Rule out Valo Vaginitis Doxy 100mg bd. Zocon 150mg weekly Levocet 5mg bd. Multivitamin and antioxidants orally. Improve general health and personal hygiene. Clean area with diluted betadine lotion apply ciprolar FC oint locally. Keto soap and lotion locally HS. Deworming.
Lichen sclerosus DD can be Vulvovaginal candidiasis, bacterial Vaginosis, Trichomoniasis
?? Fordyce angiokeratomas. ??Pappular-angiomatous lession on the lt labium majus. ?? Hyperkeratosis on the larger lession. Adv:-Histopathology.
Papular scabies Permethrin 5% topically Tab Azithral 500mg daily×5days Tab Montair LC daily Tab Albendazole+Ivermectine (400/12) hs×1day Ivermectine soap
Scabies D/D Lichen sclerosis Angiokeratoma
SUGGESTIVE OF LICHEN SCLEROSUS DD VULVO VAGINITIS
Vaginitis Doxy Zocon Miconazole
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