Ongoing treatment regime (including for sores/ulcers)

BSF and talkhealth teamed up to offer an online expert clinic on Lichen Sclerosus. We know that a lot of our members are affected by vulval skin conditions, in fact, we have one of the largest lichen sclerosus communities online!
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Sarah Jay
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Joined: Wed Feb 16, 2022 11:27 am
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by Sarah Jay on Wed Feb 16, 2022 12:03 pm

Ongoing treatment regime (including for sores/ulcers)

I've had LS for 5 years or so, but have never been given a detailed treatment/management plan. I was advised to use Dermovate when I needed to. (Which I haven't on the whole as I didn't often have obvious symptoms to start with. Although my labia started to fuse before I was diagnosed, which is a bit problematic as the fusion tears on a regular basis). I've recently read that women with LS should use Dermovate twice weekly as a preventative measure. (Or maybe Betnovate?) Given I've also had VA for around 9 years, what would an effective detailed self-management plan look like? (I currently use Vagifem twice a week for the VA, and came off systemic HRT last year due to my age and the fact I'd already been taking it for quite a while).

I recently developed 5-6 open sores on my vulva. They started off round, but two have now joined together to form a long rectangular sore (the length of a fingernail). Urination is painful, and sitting is somewhat uncomfortable. In a phone consultation my GP practice recommended using Dermovate twice daily for 10 days. But given advice not to use Dermovate on open skin, I'm worried in case the sores aren't due to LS but a virus or infection. (I also have a large tear in my labial fusion). Following another phone appointment a different GP has suggested stopping the Dermovate and taking a course of antibiotics. Got a face-to-face GP appointment next week. Any advice? What should I expect from GP at my next appointment? What should I be asking?

With hindsight I wonder if I'd have been better off seeing a private specialist? Is it too late? Should I consider it? (I don't have lots of money to spare, but would consider it a priority if the advice would be better than via the NHS).

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Dr Karen Gibbon
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Joined: Wed May 06, 2020 12:28 pm
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by Dr Karen Gibbon on Wed Feb 16, 2022 6:30 pm

Re: Ongoing treatment regime (including for sores/ulcers)

I'm sorry you've clearly had a lot to contend with! The causes of vulval ulceration are many and taking viral swabs for persistent ulceration lasting several days is very important. You can seek an appointment with your local sexual health clinic to have these swabs taken and more importantly to be properly examined. Just using dermovate alone is not likely to be successful for undiagnosed ulceration. In the longer term twice weekly dermovate for maintenance treatment for LS is generally a good idea.
Dr Karen Gibbon
Consultant Dermatologist

http://www.talkhealthpartnership.com/on ... gibbon.php

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