{"id":2492,"date":"2019-12-15T09:27:33","date_gmt":"2019-12-15T09:27:33","guid":{"rendered":"http:\/\/papergp.com\/index.php\/womens-health\/vulval-issues\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"vulval-issues","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/womens-health\/vulval-issues\/","title":{"rendered":"Vulval issues"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">General history<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>PMH, FH<ul><li>Skin (atopy, psoriasis)<\/li><li>Autoimmune issues (thyroid, T1DM, vitiligo)<\/li><li>Lichen sclerosus or planus<\/li><\/ul><\/li><li>DH<\/li><li>STI history<\/li><\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Vulval cancer<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>Lump, ulcer, bleeding<\/li><\/ul>\n\n\n\n<ul class=\"wp-block-list\"><li>Tx <ul><li>2ww referral<\/li><\/ul><\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">VIN<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>Discoloration, warty change, history of CIN<\/li><\/ul>\n\n\n\n<ul class=\"wp-block-list\"><li>Tx <ul><li>Refer to vulval clinic<\/li><\/ul><\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Post-menopausal atrophy<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>Tx<ul><li>Ovestin cream 3\/12 &#8211; if no response, refer to vulval clinic<\/li><\/ul><\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Psoriasis<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>Dry, flakey skin (especially in hair bearing areas)<\/li><\/ul>\n\n\n\n<ul class=\"wp-block-list\"><li>Tx <ul><li>Moderate potency topical steroid BD 2\/52 &#8211; then ON 2\/52 &#8211; then taper <\/li><li>If no response in 6\/52, refer to vulval clinic<\/li><\/ul><\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Lichen simplex<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>Dry, lichenified skin, with a history of atopy<\/li><\/ul>\n\n\n\n<ul class=\"wp-block-list\"><li>Ix<ul><li>FBC + ferritin (replacing iron deficiency treats many cases)<\/li><\/ul><\/li><li>Tx<ul><li>Moderate potency topical steroid BD 2\/52 &#8211; then ON 2\/52 &#8211; then taper  If no response in 6\/52, refer to vulval clinic  <\/li><\/ul><\/li><\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Lichen sclerosus or planus<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li>Pale, white, shiny skin (esp if vulval architecture is disrupted)<\/li><\/ul>\n\n\n\n<ul class=\"wp-block-list\"><li>Ix<ul><li>Bloods &#8211; TFT, HbA1c<\/li><\/ul><\/li><li>Tx<ul><li>High potency topical steroid ointment ON 1\/12 (Clobetasol proprionate 0.05%) &#8211; reduce to alternate nights for 1\/12 &#8211; reduce to twice\/week &#8211; review in 6 months<\/li><li>Refer if no response in 6 weeks or not confident about diagnosis (or if sexual dysfunction present)<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>General history PMH, FH Skin (atopy, psoriasis) Autoimmune issues (thyroid, T1DM, vitiligo) Lichen sclerosus or planus DH STI history Vulval cancer Lump, ulcer, bleeding Tx 2ww referral VIN Discoloration, warty change, history of CIN Tx Refer to vulval clinic Post-menopausal atrophy Tx Ovestin cream 3\/12 &#8211; if no response, refer to vulval clinic Psoriasis Dry, &hellip; <a href=\"https:\/\/papergp.com\/index.php\/womens-health\/vulval-issues\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Vulval issues<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":122,"menu_order":94,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2492","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/2492","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=2492"}],"version-history":[{"count":2,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/2492\/revisions"}],"predecessor-version":[{"id":2496,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/2492\/revisions\/2496"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/122"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=2492"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}