Vaginal and vulvar disorders Quiz: Ace Your Exams
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A 50-year-old woman comes to the clinic due to vulvar itching over the past few months. The patient reports experiencing an irritating itch that often awakens her at night. She has tried multiple lotions without relief. Medical history is remarkable for atopic dermatitis, which has been effectively managed with a steroid cream. The patient does not have any burning sensation during urination, dyschezia, or dyspareunia. The patient has no history of sexually transmitted diseases and is in a monogamous relationship with her partner. The patient’s temperature is 37.4°C (99.3°F), pulse is 68/min, and blood pressure is 130/75 mmHg. Physical examination of the vulva reveals a thick, leathery lesion covering most of the left labia majora. A close up of the lesion is shown below: 
Retrieved from: Wikimedia
Which of the following is the most likely diagnosis?

Retrieved from: Wikimedia
Which of the following is the most likely diagnosis?
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