ITCH IN OUTER GENITAL ORGANS IN GIRLS
Many diseases such as bacterial infection, fungal infection, pinworm infection, some allergic conditions, various dermatitis, lichen sclerosis are the most common causes of itching in the vulva (external genital organs) in girls. Among these, the disease called lichen sclerosis is frequently overlooked in girls, and it leads to the chronicity of the disease as a result of wrong treatment. For this reason, lichen sclerosis will be examined in more detail.
Lichen sclerosus is a chronic, inflammatory, autoimmune skin disease that mostly affects the skin of the vulva. This disease is a disease that affects young girls, adolescents, young girls and all ages. The vulva is white, slightly glossy, flat. The skin surface is thin. This causes bleeding under the skin. In severe cases of lichen sclerosis, scarring occurs in the genital area, and the labia can be covered with thinning clitoris scar tissue. It is a chronic disease related to the immune system. It is not contagious.
Lichen sclerosis symptoms:
– Severe itching of the vulva
-Vulvar skin fragile, pale white.
– Ecchymotic skin with cracked blood vessels.
– Minor bleeding from cracks in the skin
Scar tissue covering the labia or clitoris.
Diagnosis;Generally, it can be done by looking at the skin of the vulva, but sometimes it may be necessary to take a biopsy.
If left untreated, scarring occurs in many parts of the vulva, and the vulva narrows. Pain during urination and intercourse.
Treatment: Corticosteroids are used to relieve the symptoms of lichen sclerosus. Clobetasol propionate, a potent corticosteroid, is the most preferred cortisone. This drug reduces the body’s immune response. This drug is applied until the vulvar skin returns to normal. The duration of drug administration varies from patient to patient, according to the patient’s recovery process and reaction to the drug. This medicine will not heal an already existing scar. The patient should be informed about the side effects.
In the majority of cases, the symptoms are controlled and the skin returns to normal. In severe cases that do not respond to medication, surgical treatment is required. If sexual intercourse is not possible, the vagina should be enlarged with vaginal dilators.
Treatment with pimecrolimus is very successful in cases that recur after treatment with clobetasol propionate. This treatment also does not cause dermal atrophy, striae, burning sensation in the vulva, and suppression of the hypothalamo-pituitary axis.
Topical Tacrolimus cream 0.1% treatment is a safe and effective treatment in cases of long-lasting active lichen sclerosis. The success of the treatment is measured by the significant improvement in the symptoms of lichen sclerosis (erythema, erosion, induration, itching). With this drug, the maximum effect is achieved in the majority of patients after 10-24 weeks of treatment. There are also patients whose treatment lasts up to 18 months. There are no serious side effects with this drug.
The important point in the treatment of lichen sclerosis is to treat the vulva before the scar is formed and not to be late in the treatment.
Kiss. Dr. Kutlugul Yuksel
Gynecology and Obstetrics Specialist