Vulva atrophy, primaryN90.5
DefinitionThis section has been translated automatically.
Progressive atrophy of the labia majora and minora with stenosis of the introitus vaginae and subsequent, partly malignant degenerated leukoplakia vulvae of the mucosa. Probably variant of the lichen sclerosus et atrophicus. S.a.u. vulva atrophy, senile.
ManifestationThis section has been translated automatically.
Occurs mainly during menopause, but also in younger women and girls.
Differential diagnosisThis section has been translated automatically.
Senile vulva atrophy.
General therapyThis section has been translated automatically.
Exclusion of underlying diseases such as diabetes mellitus, candidiasis, trichomonas infection, worm infections.
External therapyThis section has been translated automatically.
- Application of creams containing estrogen and progesterone(e.g. Linoladiol N, Oestro-Gynaedron M). In case of itching, additional sitz baths with Kamillosan or synthetic tannic acid (e.g. Tannolact). Short-term use of low-concentration topical glucocorticoids is recommended, but is controversial because of the chronicity of the clinical picture and taking into account the steroid atrophy that occurs with prolonged use R120 R030 R029.
- Good success can be achieved with intralesional glucorticoid injections such as with triamcinolone acetonide (e.g. Volon A diluted 1:1 with the local anesthetic Scandicaine) with regard to itching. Caution. Painful procedure! Under certain circumstances, perform injections under anesthesia or in combination with cryosurgery (open spray procedure).
- Nourishing externals such as dexpanthenol cream R065 or estrogen-containing hydrophilic creams and meticulous intimate care (bidet use after toilet visit, if bidet is not available, a good option would be the HappyPo Easy-Bidet (mobile hand-bottom shower). Dabbing with damp cloth, then oil-soaked hygienic wipes) are highly recommended. Before sports or longer marches, apply a hydrophilic or hydrophobic ointment, e.g. Vaselinum album.
- Regular check-ups and exclusion of malignant degeneration (PE, otherwise surgical referral). In case of stenosis, referral for plastic surgery (vulvaplasty). In case of leukoplakic accentuation, surgical therapy is also preferred, e.g. cryosurgery (open spray procedure) is used here. Gynecological co-care.
Internal therapyThis section has been translated automatically.
LiteratureThis section has been translated automatically.
- Camacho-Martinez F et al (1987) International dermatosurgery: reconstructive treatment of the vulva- a new procedere: experience on 23 cases over 4 years. J Dermatol Surg Oncol 13: 488-494
- Dalziel K L et al (1991) The treatment of vulval lichen sclerosus with a very potent topical steroid (clobetasol propionate 0.05%) cream. Br J Dermatol 124: 461-464
- Khumalo S et al (2001) Vulval punch biopsies: what is the experience of patients and do they alter management? J Obstetrates Gynaecol 21: 181-183
- Lewis FM (2002) Vulval disease from the 1800s to the new millennium. J Cutan Med Surg 6: 340-334
- Rolfe KJ et al (2003) TP53 mutations in vulval lichen sclerosus adjacent to squamous cell carcinoma of the vulva. Br J Cancer 89: 2249-2253