Vulval 'chronic inflammation'

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Frances489
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Joined: Wed Oct 12, 2016 3:17 pm
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by Frances489 on Wed Mar 01, 2017 2:53 pm

Vulval 'chronic inflammation'

I'm 70 years old. Three months ago I went to my GP with severe vulval itching and inflammation - something which had developed over 18 months. I was initially prescribed Betnovate and then Dermovate, which I used twice a day, then once a day, for two months. This worked reasonably well, but didn't clear all the inflammation. My GP did a biopsy and the result was 'chronic inflammation'. He had initially thought I had lichen sclerosis, but, after the biopsy result, would not be drawn on whether it was LS or not. At my last appointment, he told me to use the Dermovate to ease itching, then to stop using it until the itching returned, and so on. At the moment, I don't have an appointment to see him again.

I stopped using the steroid while my stitches healed, but now I am using the Dermovate once a day, as the itching and discomfort have returned.

Two questions, please.
Firstly, is it possible that 'chronic inflammation' is in fact LS? I believe a better understanding of this 'chronic inflammation' would enable me to manage it better.
Secondly, although I get on well with my GP, and he has a qualification in gynaecology, would I be better asking to see a specialist in vulval problems?

Thank you for any advice you are able to give me.

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Mr Jonathan Broome
Posts: 27
Joined: Mon Feb 27, 2017 12:17 pm
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by Mr Jonathan Broome on Thu Mar 02, 2017 11:08 pm

Re: Vulval 'chronic inflammation'

Hello
I think you're probably right in that the 'chronic inflammation' may represent Lichen Sclerosus, there just may have been an issue with the biopsy site/interpretation. Management to some extend is the same so rather than repeating the biopsy at this stage I'd suggest getting on top of the symptoms. Dermovate is fine to use for short periods of time 4-6 weeks but it's not ideal for long term use. Once on top of the symptoms you should use a less potent steroid such as hydrocortisone 1% daily (its perfectly safe to use this long term) and only go back to the dermovate if you get a flare up of symptoms. LS is a lifelong condition and if not treated will return with flare ups. You also need to hydrate the vulval area (sudocream, E45 cream, vaseline) and you can try oilatum in the bath. Other advice about wearing cotton/loose fitting underwear, avoiding perfumes, soaps are relevant and be gentle drying the area after bathing, a hairdryer on gentle heat may be helpful. Any changes to to vulval area should be reported to your GP.
Regards
Mr Jonathan Broome
Consultant Gynaecological Surgeon - MB ChB, MRCOG

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

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