Vulval itch that isn’t thrush

CASE STUDY

MARY tried to hold back the tears. Over the last three and a half years she had seen three general practitioners and one gynaecologist before being given her correct diagnosis of lichen sclerosus (LS). 

She had been told many times that she had ‘thrush’ and had been advised to use hydrocortisone cream applications when she was itchy. Despite doing this, Mary was always itchy and she could see on examining herself that things were changing. 

Physical examination confirmed that her labia minora had ‘disappeared’ as had her clitoris as a result of uncontrolled LS and fusion of the vulval tissues. 

Discussion

Potent topical corticosteroid applications have been recognised globally as the most effective treatment to control the symptoms and progress of lichen sclerosus (LS) since the 1980s, but the message is still often lost in translation from the

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