A 30 Y/O female G3P3 HIV negative woman came with history of prolonged, intense pruritus vulvae of increasing severity. She had been treated for vulvar candidiasis several times to no avail. cervical cancer screening was normal. The vulvar examination showed excoriation and acetowhite changes, especially on the labia majora. What do you think is diagnosis for this?

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IT'S A..CASE OF.. PRURITUS VUALVAE.. CAUSES.. * VULVOVAGINITIS.. * HPV .. * ANTIBIOTICS OVERUSE LEADS TO YEAST INFECTION.. * PINWORM.. NEED'S TO R/O DIABETES..

Tnx Dr Jivan Rathod
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CLINICAL IMPRESSION: LICHEN SCLEROSUS INVESTIGATION SUGGESTED: PUNCH BIOPSY DESIRED STAINS:H&E PAS AND MASSON TRICHROME IF BIOPSY SUGGESTS LS INVESTIGATE FOR AUTOANTIBODIES TO THYROID. MANAGEMENT SUGGESTED: LOCAL STEROID PREFERABLY TWICE OR THRICE A WEEK TO BREAK ITCH SCRATCH CYCLE. ONE CAN USE TACROLIMUS OR PIMECROLIMUS INSTEAD OF LOCAL STEROID. LONG TERM MONITERING DESIRED FOR DETECTING SCC IF DEVELOPE OVER A PERIOD OF DECADES. REGARDS

Vulva irritation can be caused by any moisture left on the skin. This moisture may be perspiration, urine, vaginal discharge or small amounts of stool. It may be caused by vaginal infections, vulvitis, HPV (human papilloma virus) infection, anal incontinence, Bowen's disease, or dietary irritants (caffeine, potatoes, chilli, capsicum, tomatoes, and peanuts). Treatment with antibiotics can lead to a yeast infection and irritation of the vulva. Some diseases increase the possibility of yeast infections, such as diabetes mellitus

Repeated vulvar candidiasis suggestive of Immunosuppression due to Diabetes mellitus, Steroids, or any other Immunocompromised conditions....Rule out any immunocompromised states Candidiasis should be treated It may be 1. Herpes simplex lesions 2. HPV infection 3. Vulvar malignancy

Rule out DM convincingly Vulvar Lichen sclerosus, vulvar chronic lichen planus , should be excluded by 3mm punch biopsy .

I agree Sir
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Vulvo vaginitis Doxy Zocon Miconazole

Flexural psoriasis? R/o DM.

I agree Sir
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SUGGESTIVE. OF LICHEN SCLEROSUS.. VULVOVAGINA...

Rule put DM ?Flexyla psoriasis

Thanku Dr Dinesh Sir
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Flexural psoriasis R/O diabetes

Thanx
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