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Can Lichenification take place inside the vaginal hole? (High vaginal swab is coming back negative and so is a urine test)

Lichenification refers to thickening of a skin lined surface - so yes, lichenification in the vagina can occur. What is causing it however won't be detected with either a swab or urine test. If there is altered skin in the vagina then it needs to be checked out by a gynaecologist initially.