Vulvar skin disorders (benign) Quiz: Ace Your Exams
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A 52-year-old postmenopausal woman presents to the clinic for a 3-month follow-up for chronic vulvar pruritus and soreness. She has been compliant with treatment with a medium-potency topical corticosteroid but continues to be symptomatic. The only body area affected is the genitals. The patient has not had any recent use of new soaps, detergents, or fabric softeners. She is not currently sexually active. Her past medical history is notable for hypertension, which is well-controlled with lisinopril. Her family history is unremarkable. Vital signs are within normal limits. On examination, there are violaceous, flat-topped papules and plaques on the vulvar skin, with a fine, white, reticulated pattern on the surface. There is a large erosive lesion in the vaginal introitus and yellow vaginal discharge, which were not present at the last clinic visit. Which of the following is the most appropriate next step for diagnosing this patient's condition?
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