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    Jeeban Jyoti Mishra
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    A 60-year-old female presented with a 4-year history of pruritus and whitish discoloration of the vulvar area. Examination revealed well-defined flat atrophic depigmented plaques with atrophy of the labia majora and minora and architectural loss of the clitoris. Differential diagnoses included lichen sclerosus et atrophicus, lichen planus, morphea, and vitiligo. Histopathology was recommended to rule out malignancy, sexually transmitted diseases, or associated autoimmune disorders. Management options discussed included potent topical steroids, calcineurin inhibitors, antihistamines, emollients, phototherapy, and surgery for

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    A 60-year-old female presented with a 4-year history of pruritus and whitish discoloration of the vulvar area. Examination revealed well-defined flat atrophic depigmented plaques with atrophy of the labia majora and minora and architectural loss of the clitoris. Differential diagnoses included lichen sclerosus et atrophicus, lichen planus, morphea, and vitiligo. Histopathology was recommended to rule out malignancy, sexually transmitted diseases, or associated autoimmune disorders. Management options discussed included potent topical steroids, calcineurin inhibitors, antihistamines, emollients, phototherapy, and surgery for

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    © All Rights Reserved
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    17 views6 pages

    Clinical Case Discussion

    Uploaded by

    Jeeban Jyoti Mishra
    A 60-year-old female presented with a 4-year history of pruritus and whitish discoloration of the vulvar area. Examination revealed well-defined flat atrophic depigmented plaques with atrophy of the labia majora and minora and architectural loss of the clitoris. Differential diagnoses included lichen sclerosus et atrophicus, lichen planus, morphea, and vitiligo. Histopathology was recommended to rule out malignancy, sexually transmitted diseases, or associated autoimmune disorders. Management options discussed included potent topical steroids, calcineurin inhibitors, antihistamines, emollients, phototherapy, and surgery for

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    Clinical Case Discussion

    Dr Jeebanjyoti Mishra,
    Senior resident , SCB MCH
    Examination
    • Well defined flat atrophic
    depigmented plaque
    • Atrophy of labia majora and
    Labia minora
    • Architectural loss of clitoris
    Differentials

    • Lichen sclerosus et atrophicus


    • Lichen planus
    • Morphea
    • Vitiligo
    History
    • 60 Year elderly female ,with history of pruritus and whitish
    discoloration at vulvar area for last 4 years
    • Severe and distressing pruritus
    • No dyspareunia ,mild discomfort
    • No urinary complain/Constipation

    • No extra genital lesion


    Investigations
    • Histopathology
    • Is it necessary to rule
    out
    – Malignancy
    – STD
    – Associated autoimmune
    disorder
    Management

    • Super potent topical steroid


    • Calcineurin inhibitors
    • Antihistamines,Emolients
    • Systemic therapy:
    • Methotrexate, Retinoids, Cyclosporine
    • Others :
    • Phototherapy, Photodynamic therapy , LASER
    • Surgery: Functional problems
    • Post-inflammatory scarring
    • Premalignant/Malignant

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