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Vulvar dermatoses: an NP’s approach to benign skin conditions “down there”
Finishing and women of chronic lower priced tract discomfort. Not all get is believed exhaust; vulvar skin is largely more likely than going on other locations of the web.
The flesh between the vaginal opening and the anus avginal part of the vulva but often involved in vulvar skin problems is the perineum. This is where the incision called an episiotomy is sometimes made during childbirth.
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Getting a diagnosis for vulva skin conditions Vulvar skin conditions are highly treatable, but the treatment depends on dream specific cause. And identifying the underlying diagnosis can be very challenging. Tell your clinician about any other past or present medical conditions including bladder and bowel issues and any skin problems elsewhere on your body. For example, psoriasis anywhere on the body raises the risk of a vulvar condition known as lichen sclerosus.
This condition and others are described, below, in "Vulvar conditions and their treatment. A mouth condition called lichen planus is another cause of vulvovaginal problems. The term "lichen," as applied to skin disorders, refers fancifully to skin lesions that resemble lichen on rocks. Long-term treatment with oral steroids, immune suppressants, or antibiotics can affect vulvar skin and raise the risk infection. Your clinician will want to know how you care for your vulvar skin, which can help identify possible sources of irritation. A careful and complete patient history is essential. The interview should start with having the patient define her symptom.
Prompting with a variety of descriptors itch, burn, rawness, pain, tingling, and irritation may be useful. The patient who primarily reports symptoms other than itching may have a different underlying disorder. Burning and pain, however, can occur in patients with dermatitis and lichen simplex as a result of exposure to urine or other agents on areas of excoriations or erosions. The timing of the symptoms is therefore important. Identification of the onset of symptoms helps to identify the temporal development of the current condition.
Ann Novel Asthma Immunol. Prime anogenital seizure often is infectious, with only and irritant starring british playing a role in some people.
Next, define the location of the pruritus generalized, limited to a few areas or localized to the vulva. Identify dermititus that make the pruritus better or worse e. Obtain a list of prescribed, over the counter, and alternative therapies, as well as the length of use and results associated with each one. Inquiry about personal hygiene routines douching, washing, types of detergents using for cleaning clothes.
Identify preexisting Besh, such as history of HSV, zoster, diabetes, allergic rhinits, asthma, eczema, psoriasis. Physical exam findings In dermatitis, clinical signs can range from mild erythema, swelling and scaling to marked erythema, fissures, erosions and ulcers. Do not wear nylon or other materials that hold body heat and moisture close to the skin. When should you call for help? Call your doctor or nurse call line now der,ititis seek immediate medical care if: You have a fever. You have vaginal discharge that smells bad.
You have burning or pain when you urinate. You have increased pain, dermitjtis, warmth, or redness in dermiritis vaginal area. Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if: Excessive washing of the vulva by dermiittis who fear a lack of cleanliness often aggravates atopic dermatitis instead of relieving it. Patients must be reminded that the vagina is self-cleaning, and that overzealous washing is unnecessary and can lead to painful reactions. Eczematous skin is especially susceptible to secondary infection and excoriation, which can cause variation in appearance and complicate the clinical picture.
Bacteria can take advantage of the compromised barrier function and cause impetigo in the eczema. The trademark of impetiginized skin is honey-colored crust, but secondary infection may also present as pustules or fissures. A large part of treatment is patient education and behavior modification. Although this condition lacks a cure, it can be ameliorated with proper skin care practices. Intertrigo presents as erythematous, macerated skin that is commonly pruritic and painful. Predisposing factors include diabetes, obesity, and the wearing of tight clothing, which leads to chafing.
A discussion regarding a low sugar and yeast diet is appropriate in these cases. Topical antifungals and low- to mid-potency topical corticosteroids may be used initially to decrease discomfort. Keeping the intertrigo-prone area as dry as possible can prevent subsequent flares. Use of talcum-based powders on thoroughly dried skin is helpful in warm humid weather. Although most frequently seen after menopause, lichen sclerosus can present in women of any age group, on any part of the body. In typical cases, lichen sclerosus appears as well-defined white plaques with an atrophic wrinkled surface.
If a biopsy is warranted for confirmation, NPs trained in performing a vulvar punch biopsy may collect a specimen. The skin of the vulva can be very sensitive and is subject to irritation from products such as laundry detergent, fabric softeners, body soaps, deodorized tampons or pads, and feminine hygiene products. Regular use of these products over a period of time causes irritation, burning and itching. What are the signs and symptoms of contact dermatitis? The dampness may be mistaken for discharge coming from the inside of the vagina and may be believed to be the cause of symptoms.