Approach to vulvar skin disorders Quiz: Ace Your Exams
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A 54-year-old woman presents to the gynecologist with a six-month history of progressively worsening vulvar pruritus. The pruritus is constant but worse at night. It recently has been disturbing her sleep. Her last menstrual period was three years ago. She has no abnormal bleeding or dyspareunia. She has been screened for cervical cancer according to standard guidelines, and all tests have been negative. Her most recent screening test was three years ago. Past medical history is notable for asthma controlled with a low-dose inhaled corticosteroid-formoterol as needed. Vital signs are within normal limits, and she appears well. On exam, the labia majora appear erythematous with thickened, leathery skin, and excoriations. The skin is not affixed to the underlying tissue, and no masses, ulcers, or pigmented lesions are noted. White vaginal discharge is present. Which of the following is the most appropriate next step in management?
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