Lichen sclerosus accounts for about 10 per cent of patients with vulval symptoms.(21) It affects skin anywhere on the body, but most commonly affects the genital area. The aetiology is unclear, but it is thought to be an autoimmune disorder. Lichen sclerosus can occur at any age; ten per cent of cases start in childhood and may be mistakenly diagnosed as sexual abuse.(21) It is more common in postmenopausal women.
Lichen sclerosus can be asymptomatic and the diagnosis is only made at the time of a vulval examination for an STI or cervical screening test.
It is important to recognise and treat lichen sclerosis for two reasons:
It is associated with squamous cell carcinoma of the vulva – lifetime risk of 2-6 per cent.(21)
If not treated, it can result in significant atrophy and distortion of the genital skin.
...
Buy now
Presentation
Buy now
Diagnosis
Buy now
Management
Buy now
Maintenance
Buy now
1.
Madhivanan P, Krupp K, Chandrasekaran V, Karat C, Arun A, Cohen CR, et al. Prevalence and correlates of Bacterial Vaginosis among young women of reproductive age in Mysore, India. Indian J Med Microbiol. 2008; 26(2):132-7.
Close
2.
Forcey D, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, et al. Factors associated with Bacterial Vaginosis among women who have sex with women: a systematic review. PLoS ONE. 2015; 10(12):e141905.
Close
4.
Pirotta M, Fethers KA, Bradshaw CS. Bacterial Vaginosis: more questions than answers. Aust Fam Physician. 2009; 38(6):394-7.
Close
5.
Gottschick C, Zhi-Luo D, Vital M, Clarissa M, Abels C, Pieper DH, et al. Treatment of biofilms in Bacterial Vaginosis by an amphoteric tenside pessary-clinical study and microbiota analysis. Microbiome. 2017; 5(119).
Close
7.
2015 Sexually Transmitted Disease Treatment Guidelines [Internet]. Centers for Disease Control and Prevention; 2015. Disease Characterized by Vaginal Discharge; [updated 2015 June 4; cited 2015 July 14]. Available from: https://www.cdc.gov/std/tg2015/vaginal-discharge.htm.
Close
9.
Bradshaw C, Morton AN, Hocking J, Garland SM, Morris LM, Moss LM, et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis. 2006; 193(11):1478-86.
Close
10.
Car P. Chronic vaginal discharge: causes and management O&G. 2014; 16(3).
Close
11.
Saxon C, Edwards A, Rautemaa-Richardson R, Owen C, Nathan B, Plamer B et al. British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019).[Internet]. British Association for Sexual Health and HIV: Clinical Effectiveness Group (CEG). 2019. Available from: https://www.bashhguidelines.org/media/1223/vvc-2019.pdf.
Close
12.
Fischer G. Coping with chronic vulvovaginal candidiasis. Medicine Today. 2014; 15(2):33-40.
Close
13.
Matheson A, Mazza D. Recurrent vulvovaginal candidiasis: A review of guideline recommendations. Aust N Z J Obstet Gynaecol. 2017; 57(2):139-45.
Close
21.
Fischer G, Bradford J. The Vulva: a Practical Handbook for Clinicians. 2nd Ed. Sydney, Australia: Cambridge University Press; 2016.
Close
22.
Nunns D, Mandal D, Byren M, McLelland J, Rani R, Cullimore J, et al. Guidelines for the management of vulvodynia. British Journal of Dermatology. 2010;162(6):1180-5.
Close
23.
Lynch PJ, Moyal-Barrocco M, Bogliatto F, Micheletti L, Scurry J. ISSVD classifications of vulvar dermatoses: pathologic subsets and their clinical correlates. J Reprod Med. 2007; 52(1): 3-9.
Close
25.
Ampt A, Roach V, Roberts CL. Vulvoplasty in New South Wales, 2001–2013: a population-based record linkage study. Med J Aus. 2016;205(8):365-9.
Close
