II. Definition

  1. Non-neoplastic epithelial disorders of the vulva

IV. Causes: Papulosquamous Vulvar Dermatoses

V. Causes: Bullous Vulvar Dermatoses

VI. Causes: Systemic Disease and other causes

VII. Management

  1. Mild Steroids
    1. Hydrocortisone ointment (1% or 2.5%)
  2. High Potency Steroids for Lichen Sclerosis only
    1. Child: Hydrocortisone (2.5%) topically
    2. Adult
      1. Testosterone (2%) topically
      2. Clobetasol 0.05% ointment (Ultra-high potency)
        1. Effective for Vulvar Lichen Sclerosis
          1. Cooper (2004) Arch Dermatol 140:702-6 [PubMed]
        2. Sample protocol
          1. Apply bid for 1 month then
          2. Apply daily for 1 month then
          3. Apply 1-3 times weekly prn to control symptoms
          4. Taper to Kenalog 0.1% as symptoms controlled
  3. Topical Anesthetics
    1. Lidocaine (Xylocaine) 5% ointment
    2. Avoid benzocaine
      1. Risk of Allergic Contact Dermatitis
  4. Bland Emollients
    1. Milk compresses
    2. Vegetable oil compresses
    3. Plastic ice pack

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