Steroid cream for vulvar itching

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Lichen sclerosus is treated with potent topical steroids to alleviate symptoms, prevent architectural damage, and reverse histologic changes. 31 – 33 The recommended regimen for lichen sclerosus begins with a high-potency corticosteroid (., clobetasol propionate % ointment [Temovate]) used daily until all active lesions have resolved (usually in two to three months), then tapered to once or twice per week. 32 , 33 A 30-g tube of clobetasol ointment should last three months or longer. 33 Alternatively, the patient can use a moderate-potency steroid (., beta-methasone valerate % cream [Beta-Val]) to maintain remission. Despite known side effects of long-term topical steroid use, one small study showed that treating lichen sclerosus with moderate-potency topical steroids for up to 39 months caused no side effects other than erythema. 34

Vulvar dermatoses may be manifested by itching and, in some cases, pain ( Figures 3 through 5 ) . Vulvar dermatoses include papulosquamous (thick and scaly) lesions. Erosions or ulcers may result from excessive scratching. If the patient has blisters or ulcers and denies scratching, the cause may be a vesiculobullous disease. Differential diagnoses of papulosquamous lesions and vesiculobullous lesions are included in Table 2 . 6 Neoplastic lesions include extramammary Paget's disease, squamous cell carcinoma, lichen sclerosis and vulvar intraepithelial neoplasia. 6 Colposcopy and biopsy as indicated are recommended to rule out dermatoses or neoplastic lesions ( Figure 6 ) . A recent study showed the most common cause of symptomatic vulvar disease (itching or burning) to be dermatitis or another dermatosis. 18

Steroid cream for vulvar itching

steroid cream for vulvar itching


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