Vulvar eczema?

[Frances489]

I'm 71. I've had vulvar itchiness and inflammation for about 18 months now. Dermovate reduced the inflammation, which, initially covered the whole of the vulva, but left two red, inflamed, itchy areas which have never cleared. My GP took a biopsy of one of these areas and the result showed 'chronic inflammation'. I saw a dermatologist and I am to have another biopsy in 10 days. The only other skin problem I have is an occasional flare-up of pustular rosacea.

I have worn pant liners for about 20 years, regularly wore trousers and sit on a soft sofa to read, knit, watch TV etc. Since I have had this problem, I have stopped wearing pant liners and am wearing skirts more often. I am also washing with Dermol and using Hydromol as an emollient. While improved, the itchy soreness remains.

Is it likely that eczema could be the root of a problem like this? My GP told me I definitely don't have any sign of atrophy.

[Dr Sharon Wong]

Dear Frances

Many thanks for your question. Sorry to hear you have been having such a difficult time with your skin.
The results of your first biopsy is reassuring but I completely agree that persistent patches which have been more resistant to treatment should be re-biopsied. Eczema is certainly a common cause of an inflammatory rash in the genital area but there are other chronic inflammatory disorders which can look and feel very similar and may require longer courses of steroid creams.
You are already doing all the right things by using cream based soaps, emollients and wearing light loose clothing. I am sure your Dermatologist will be able to guide you further on treatment once the results from the second biopsy are available but if the second biopsy still shows features of eczema it may be worth condiering patch testing to exclude an allergic eczema.

Best of luck