Common Benign Chronic Vulvar Disorders.

MedStar author(s):
Citation: American Family Physician. 102(9):550-557, 2020 11 01.PMID: 33118795Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Vulvar Diseases/pp [Physiopathology] | *Vulvar Diseases/th [Therapy] | Adult | Chronic Disease/dt [Drug Therapy] | Chronic Disease/th [Therapy] | Female | Humans | Lichen Planus/di [Diagnosis] | Lichen Planus/th [Therapy] | Lichen Sclerosus et Atrophicus/di [Diagnosis] | Lichen Sclerosus et Atrophicus/th [Therapy] | Middle Aged | Neurodermatitis/di [Diagnosis] | Neurodermatitis/th [Therapy] | Vulva/in [Injuries] | Vulva/ph [Physiology] | Vulva/pp [Physiopathology] | Vulvar Diseases/di [Diagnosis] | Vulvodynia/di [Diagnosis] | Vulvodynia/th [Therapy]Year: 2020Local holdings: Available online from MWHC library: 1998 - present, Available in print through MWHC library: 1998 - 2006ISSN:
  • 0002-838X
Name of journal: American family physicianAbstract: Common benign chronic vulvar conditions include genitourinary syndrome of menopause (formerly called vulvovaginal atrophy), lichen sclerosus, lichen planus, lichen simplex chronicus, and vulvodynia. Genitourinary syndrome of menopause results from the hypoestrogenic state that leads to atrophy of normal vulvar and vaginal tissues. It is typically treated with lubricants, moisturizers, and intravaginal estrogen. Lichen sclerosus is an inflammatory condition characterized by intense vulvar itching. It is treated with topical steroids or, in some cases, topical calcineurin inhibitors. Patients with lichen sclerosus are at risk of vulvar squamous cell carcinoma and should be monitored closely for malignancy. Lichen planus is an inflammatory autoimmune disorder that can affect the vulva and vagina in addition to other skin and mucosal surfaces. The first-line treatment is topical steroids, and significant scarring can occur if left untreated. Lichen simplex chronicus manifests as persistent itching and scratching of the vulvar skin that leads to thickened epithelium. Breaking the itch-scratch cycle, often with topical steroids, is the key to treatment. Vulvodynia is a common vulvar pain disorder and is a diagnosis of exclusion. A multimodal treatment approach typically includes vulvar hygiene, physical therapy, psychosocial interventions, and antineuropathy medications.All authors: Iglesia C, Ringel NEOriginally published: American Family Physician. 102(9):550-557, 2020 Nov 01.Fiscal year: FY2021Date added to catalog: 2020-12-29
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Journal Article MedStar Authors Catalog Article 33118795 Available 33118795

Available online from MWHC library: 1998 - present, Available in print through MWHC library: 1998 - 2006

Common benign chronic vulvar conditions include genitourinary syndrome of menopause (formerly called vulvovaginal atrophy), lichen sclerosus, lichen planus, lichen simplex chronicus, and vulvodynia. Genitourinary syndrome of menopause results from the hypoestrogenic state that leads to atrophy of normal vulvar and vaginal tissues. It is typically treated with lubricants, moisturizers, and intravaginal estrogen. Lichen sclerosus is an inflammatory condition characterized by intense vulvar itching. It is treated with topical steroids or, in some cases, topical calcineurin inhibitors. Patients with lichen sclerosus are at risk of vulvar squamous cell carcinoma and should be monitored closely for malignancy. Lichen planus is an inflammatory autoimmune disorder that can affect the vulva and vagina in addition to other skin and mucosal surfaces. The first-line treatment is topical steroids, and significant scarring can occur if left untreated. Lichen simplex chronicus manifests as persistent itching and scratching of the vulvar skin that leads to thickened epithelium. Breaking the itch-scratch cycle, often with topical steroids, is the key to treatment. Vulvodynia is a common vulvar pain disorder and is a diagnosis of exclusion. A multimodal treatment approach typically includes vulvar hygiene, physical therapy, psychosocial interventions, and antineuropathy medications.

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