Elsevier

Dermatologic Clinics

Volume 28, Issue 4, October 2010, Pages 639-648
Dermatologic Clinics

Therapeutic Principles in Vulvovaginal Dermatology

https://doi.org/10.1016/j.det.2010.07.001Get rights and content

Section snippets

General measures

There are several general measures that are essential for the successful treatment of any vulvovaginal disease. Despite adequate diagnosis and treatment, patients may fail to improve if these fundamentals are not addressed. These include educating patients about the nature of their disease, addressing psychosexual issues, stopping irritants, using appropriate vehicles for medications, anticipating and treating iatrogenic disease, prescribing estrogen when appropriate, and having a rescue plan

Topical corticosteroid therapy

Topical corticosteroids are the mainstay of treatment of many vulvovaginal diseases, including lichen sclerosus, lichen planus, and other pruritic diseases. The modified mucous membranes are relatively steroid resistant, and often potent or superpotent corticosteroids, such as clobetasol proprionate, are required for successful treatment.7 A common error in treating vulvar diseases is using a topical steroid that is not potent enough for too little period of time. It is rare to see atrophy of

Summary

Vulvovaginal disease, like many dermatologic diseases, tends to be chronic. Similar to treatment of diseases like atopic dermatitis, chronic vulvovaginal disease requires a multifaceted approach, often addressing multiple issues concurrently. General principles apply to all vulvovaginal patients and must be considered in each patient for treatment to be ultimately successful. The goal of treatment is often control, not cure.

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