A 65-year-old woman with a history of well-controlled vulvar lichen sclerosus presents to your clinic with acutely worsening vulvar pruritus and pain that feel like paper cuts. She has been using topical triamcinolone 0.1% regularly without improvement. Examination reveals the findings seen in Figure 1.
|What is the most likely diagnosis||What test(s), if any, should you consider||What percent of patients Experience at least one Episode of this diagnosis?|
A. Lichen sclerosus flare
|A. Wet preparation (saline and 10% KOH)||A. 10%|
|B. Vulvar candidiasis||B. Yeast culture, and if positive, identification of species||B. 25%|
|C. Vulvovaginal atrophy||C. Vulvar biopsy||C. 50%|
|D. A & B||D. 75%|
Hope K. Haefner, MD, is on the advisory board of Prestige, Inc.
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