Case: Dr O’Mahony, Nurses Sarah Ellis and Dianne Harvey (
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Case: Dr O’Mahony, Nurses Sarah Ellis and Dianne Harvey (

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Case: Dr O’Mahony, Nurses Sarah Ellis and Dianne Harvey (




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Presentation on theme: "Case: Dr O’Mahony, Nurses Sarah Ellis and Dianne Harvey ("— Presentation transcript:

Slide1

Case: Dr O’Mahony, Nurses Sarah Ellis and Dianne Harvey (

Dermatol

referral)

This 19 year old attended A&E two months ago with some vaginal bleeding and it was diagnosed as a vaginal tear when she was examined there and she was reassured there was nothing to be done. She then saw her GP as it kept happening. Her GP gave her Canesten HC which brought about a slight improvement. Her GP then found her to be chlamydia positive and referred her to us.

On examination, she has clinically very obvious Lichen Sclerosus involving labia, clitoris and

introitus

. There doesn’t appear to be any perianal

involvement.

For

some symptomatic relief, I am giving her 1% Hydrocortisone

.

No family history of eczema or

psoriasis.

Slide2

Note the pale atrophied

vulval

skin, the almost complete disappearance of the labia

majora

and

minora

, the distinct line showing where they have sealed together and disappeared. 

The

clitoris is still visible but the clitoral hood was adherent and that would have progressed.  With the narrowed

introitus

its easy to see how sex would be painful and splitting would

occur

.  Intensive (BD) treatment with a very potent steroid for months, with regular review is needed.  Continued Rx for life is

usually

necessary.

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