Vulvar irritation in a 27-year-old woman

November 17, 2017
Diana Curran, MD

Dr Diana Curran, MD is associate Professor, Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor.

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John O. DeLancey, MD
John O. DeLancey, MD

Norman F. Miller Professor of Gynecology, Director, Pelvic Floor Research, Group Director, Fellowship in Female Pelvic Medicine and Reconstructive Surgery

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Hope K Haefner, MD

Dr Hope K Haefner, MD, is Profesor in the Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor.

A 27-year-old woman presents with an 18-month history of vulvar irritation. She has tried multiple agents for her condition including topical steroids, Vagisil, antibiotics, and fluconazole without relief. What's your diagnosis?

Case 3

A 27-year-old woman presents with an 18-month history of vulvar irritation. She is otherwise healthy except for episodes of depression. She has tried multiple agents for her condition including topical steroids, Vagisil, antibiotics, and fluconazole. She used oral steroids but developed knee pain. Tacrolimus has not helped. A biopsy revealed lichen simplex chronicus. Immunofluorescent studies were negative.

Can you make the diagnosis?