diagnosis and treatment

Last reviewed 01/2018

Differential diagnosis includes psoriasis, mycosis fungoides, lichen planus and lichen amyloidosis (1).

A biopsy may be necessary to confirm the diagnosis.

The inflammation may be reduced by topical steroids; the itching by antihistamines by mouth. Tar or ichthyol - containing preparations may be used for their antipruritic and keratolytic effects; occlusive dressings, to prevent scratching.

Intralesional steroids such as triamcinolone are often effective. Topical tacrolimus has also proven to be effective (1).

Patients should be advised to stop rubbing and scratching the areas involved, and the itch-scratch cycle should be broken.

Amitriptyline and SSRI have given good results in controlling the subconscious scratching in the disease of anogenital region (2).

Reference:

• (1) Lotti T et al. Prurigo nodularis and lichen simplex chronicus. Dermatol Ther. 2008;21(1):42-6.
• (2) O'Connell TX et al. Non-neoplastic epithelial disorders of the vulva. Am Fam Physician. 2008;77(3):321-6