Abstract
Abstract
Background:
Lichen simplex chronicus (LSC) is an eczematous disease caused by cell-mediated autoimmune inflammation that presents as an erythematous and distressingly pruritic area that develops into a thickened, indurated, and atrophic area. U.S. prevalence is ∼0.5% and most commonly involves the labia minora. Often, an itch–scratch–itch cycle perpetuates this condition. Scratching causes intense pleasure, which could lead to excoriation, lichenification, depigmentation, and chronic dermatitis. Itching may be intensified at night. Common triggers are sweating, stress, walking, irritation from clothing and panty-liner–based infections.
Case:
A 22-year-old nulligravida presented in a clinic for emergency room follow-up with a diagnosis of an ovarian cyst and pyelonephritis that were treated with proper antibiotics. A wet mount was diagnostic for bacterial vaginosis, so the patient was treated with the indicated antibiotic and was scheduled for follow-up at 1 month. After multiple months of treatment with no improvement, she was referred to a vulvovaginal-specialized clinic.
Results:
At the specialized clinic, an abnormal lesion involving the anal and intergluteal areas, with a small portion of the vulva were seen. These lesions were described as soft, whitish, and hypopigmented. A punch biopsy was performed, and a pathology test confirmed LSC. She was prescribed a high-potency topical steroid, and 2 weeks later her symptoms were almost completely resolved with great improvement in the vulvar and perianal areas.
Conclusions:
LSC is an eczematous disease that usually presents in middle-aged women with the chief complaint of pruritus that is relieved by scratching. (J GYNECOL SURG 33:273)
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