Skin changes, such as color changes or thickening 5. Evaluation of women with pruritus involves taking a detailed history, which often takes a considerable amount of time, and performing a thorough physical examination, with laboratory tests guided by clinical findings. 2011;6:441–457. 2006;113:832–834. Vulvar pruritus--a symptom, not a disease. Burning with urination 6. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Vulvar Pain. Positive prick-tests with husband's semen and blood tests for specific IgE led to the diagnosis of type 1 hypersensitivity to semen, with disappearance of both vulvar … What you need to know about post-viral fatigue, How to treat constipation and hard-to-pass stools. 2019;24:24–27. Sexually … In addition to the immunological aspects of lichen sclerosus pathogenesis, which appears to involve a local cell-mediated dermal response to an antigen which has not yet been identified with certainty 37), a preponderance of cytotoxic CD8+ and CD57+ lymphocytes was found in the inflammatory cells present in lichenoid lesions—similar to the proliferation of CD8+ and CD57+ lymphocytes in chronic antigen-mediated inflammatory reactions 38). Diagnosis is based on associated clinical findings involving the oral mucosa and/or the skin and on vulvar biopsy. Besides itching, other symptoms that come with bacterial vaginosis are inflammation, burning, discharge, and a fishy-smelling odor. Epub 2014 Jan 7. Sensitisation of vulval skin. In a study with 350 lichen sclerosus patients, 21.5% of patients had one or more autoimmune diseases, 21% had a family history of autoimmune disease and 42% had autoantibodies in titers of >1:20 40). Clinical practice guideline for the management of candidiasis: 2016 Update by the infectious diseases society of America. What could be causing your pins and needles? The pattern of the itching (cyclical or sporadic), its location (localised or diffuse) and the existence of other symptoms (discharge, burning, dryness, dyspareunia and bleeding) should also be determined. Kuse E-R, Chetchotisakd P, Cunha C, et al. Using this classification system, the range of potential differential diagnoses can be narrowed down. Occasionally, early in the course of the problem, the vulva appears entirely normal. The vulva may appear pale or pink, sometimes with a white lacy pattern. The Bartholin glands are on either side of the vaginal opening beneath the skin. Use a bland, unscented moisturiser as a soap substitute. Examination will probably involve your doctor looking at the skin of your vulva and may also involve an internal (vaginal) examination. Despite the lack of convincing long-term data regarding the therapeutic targets, it appears that the use of probiotics reduces the vulvovaginal candidiasis recurrence rate 27). The following may also help ease an itchy vulva, whatever the cause. In most cases, a cause can be found for an itchy vulva (pruritus vulvae). Most of the time, when a cause can be found, the cause is treated and the itch improves. Dtsch Arztebl Int. The essential elements of treatment are topical/oral antimycotic drugs and high-potency glucocorticoids, along with consistently applied, basic moisturizing care and the avoidance of potential triggering factors. What is the symptoms of Pruritus Vulvae? The irritation is often caused by friction or chemicals. Cham: Springer International Publishing. 75% of women will have at least one episode of vulvovaginal candidiasis during their lifetime and about 8% will have chronic vulvovaginal candidiasis (at least 4 recurrences/year) 11). Petricevic L. Das vaginale Mikrobiom. 3/100 000 women in Germany, – Early form: erythema, erosions– Late form: white, firm plaques, bleeding into skin, scarring, atrophy, fissures, exaggerated skin markings, – Early form: charact. Sherman V, McPherson T, Baldo M, Salim A, Gao X, Wojnarowska F. The high rate of familial lichen sclerosus suggests a genetic contribution: an observational cohort study. Referral guidelines for suspected cancer: quick reference guide. Try our Symptom Checker Got any other symptoms? Use of transcutaneous electrical nerve stimulation for chronic pruritus. 1990;126:1043–1045. Wear loose-fitting absorbent underwear and outer clothing. whitish reticulate (Wickham) striae, Skin-colored papules and nodules, white and red plaques, acetowhite lesions (after application of 5% acetic acid), erosions (especially with differentiated VIN), Poorly marginated erythematous lesions on the labia majora and labia minora, edema (acute), lichenification (chronic), Well-demarcated, slightly scaly, erythematous red plaques, accompanying fissures and rhagades, Pruritus, erythema, increased vaginal discharge (white, curd-like, no odor), – Early form: pruritus, burning, pain– Late form: dyspareunia, burning, vaginal stenosis, Pruritus, burning, soreness, often asymptomatic, pH value: normal (< 4.0) lactobacilli : yes leukocytes: increased clue cells: none microscopy: pseudomycelium & blastospores, History, clinical examination, typical figure-of-8 pattern surrounding the vulva and anus; histological confirmation by biopsy, if required, History, clinical examination, characteristic Wickham striae, vaginal involvement, histological confirmation by biopsy, Vulvoscopy, histological confirmation by biopsy, History, clinical examination; if necessary, patch test, Typical involvement of labia majora, characteristic non-involvement of labia minora, – Acute: Antifungal agent (e.g. Throbbing 7. See if you are eligible for a free NHS flu jab today. In a randomized controlled trial with 531 patients with invasive candidiasis, micafungin (100 mg/day or 2 mg/kg body weight per day) was as effective (89.6% success rate in both groups) as liposomal amphotericin B (L-AmB) (3 mg/kg body weight), but caused fewer adverse events 16). Objective To determine whether human papillomavirus (HPV) was responsible for symptoms in women with vulvar pruritus, pain and… Expand. Lichen planus may present as violaceous or hyperpigmented papules with a white reticulated network (thighs), appear similar to lichen sclerosus; erosive lichen planus causes tender well-defined red patches and erosions in the introitus/vagina and is not usually itchy. Rapid resolution hinges on an accurate diagnosis. Local anaesthetic cream or injection is used to numb the skin first so that it doesn't hurt. The neuropathy may be caused by injury, surgery or disease locally (pudendal entrapment), within the pelvis or in the spine. Vaginitis, also known as vulvovaginitis, is inflammation of the vagina and vulva. However, depending on what the cause is, treatment is sometimes prolonged or may need to be repeated. Signs and symptoms can include vaginal dryness, pain with sex, bladder symptoms, frequent urinary tract infections (UTIs), burning, itching, and irritation. 2001;202:198–202. Mendling W. Guideline: Vulvovaginal candidosis (AWMF 015/072), S2k (excluding chronic mucocutaneous candidosis) Mycoses. The assumption of an autoimmune pathogenesis of lichen sclerosus is also supported by data from an English study which detected IgG autoantibodies to extracellular matrix protein-1 (ECM1) in the serum of 67% of patients compared to 7% in the control group 41). MoisturisersBland moisturisers (emollients) such as emulsifying ointment can help to ease the itch. In some cases, a biopsy is needed to confirm diagnosis of a disease. Here are 10 reasons your vagina is itchy and how to stop vaginal itching. It is a symptom which is common to many conditions. Evidence in support of genetic causes of lichen sclerosus include familial aggregation in up to 17% of cases 34), significant correlation of lichen sclerosus with Human Leucocyte Antigen (HLA)-A28 or HLA-B44 35) and the presence of HLA-DQ7 in 66% of the affected women 36). J Clin Microbiol. Faustmannova, O., Vrablova, M., Vasku, V. Pruritus vulvae as a dermatologic symptom Pruritus vulvae is perceived by the patient as a negative, annoying sensation, a sensation which leads to scratching, which in turn causes frequent pathological efflorescences in the skin and mucous membranes of the outer genitalia. In most areas of the body, lichen planus causes itchy purple bumps sometimes streaked with white. Schwegler J, Schwarz J, Eulenburg C, et al. Pinworms can reside in the vagina or anus and cause itch when they exit at night. Urgency with urination 7. They will be able to help and it is more likely than not that a simple treatment will solve the problem. 2010;14:319–322. Strittmatter HJ, Hengge UR, Blecken SR. Calcineurin antagonists in vulvar lichen sclerosus. It can make them feel distressed and depressed and may interfere with their sex life. Since the skin in the genital area is influenced by sex hormones, the question whether hormonal medications, such as contraceptives, are taken is also an important part of the clinical history. Vulval itch, pain and burning can co-exist. When a woman with VIN does have a symptom, it is most often itching that does not go away or get better. Local oestrogen can be helpful, either used as a cream, tablet or plastic ring inserted into the vagina, where it will help just these symptoms. Disease Pictures. Dermatology. There may be an obvious or subtle rash or no signs of disease at all. See a dermatologist or gynecologist if a cause is unclear; if symptoms persist despite treatment in primary care, or if a premalignant condition such as lichen sclerosus or lichen planus is suspected 5). … 2008;144:591–598. Untreated lipine sclerosis can cause vaginal scarfing, blistering, painful sex and vascular cancer. Friedrich EG Jr. Because the underlying causes are so varied, vulvar pruritus must be understood as a symptom and not as a disease entity in itself. Pain in your pelvis may be a symptom of vaginal or vulvar cancer. Application of ultrapotent topical corticosteroids, such as clobetasol 0.05% ointment for initially 3 months, remains the first-line treatment for genital lichen sclerosus 49). All rights reserved. Using steroid cream for various skin conditions. Pruritus vulva is the inflammation and itching of vulval area. Wear loose 100% cotton underwear. Sometimes several biopsies may be taken. Common symptoms of vulvar cancer and VIN include 1. persistent itching or burning anywhere on the vulva 2. a red, pink, or white lump with a wart-like or raw surface 3. a white, rough area on the vulva 4. painful urination or bleeding 5. discharge not related to your period 6. a skin ulcer that lasts more than a month. Geburtshilfe Frauenheilkd. The conditions causing an itchy vulva often require specific treatment. Vulvar Vestibulitis Symptoms. Scratching injures the skin, which can lead to pain and secondary bacterial infection. If symptoms persist, consider the use of short-term (one to two weeks), mild potency corticosteroid cream (hydrocortisone 1%). Mohammad Ali BM, Hegab DS, El Saadany HM. COVID-19 coronavirus: what is an underlying health condition? 2015;58 S1:1–15. The primary indication is bacterial vaginosis. This can cause itch due to swelling of the veins in the vulva (vulval engorgement). Vaginal itching is a symptom that may signify something is occurring with your vagina.Signs and symptoms of itching can involve the vagina or the genital area called the vulva. Examples include: 1. Currently, a multifactorial etiology is assumed, primarily driven by genetic and immunological factors. Information about pruritus vulva causes, pruritus vulva symptoms, treatment with homeopathy medicine, or homeopathic treatment for pruritus vulva. It often takes a relapsing chronic course and is considered to be a facultative precancerous condition which can develop into squamous cell carcinoma 33). J Eur Acad Dermatol Venereol. Even though the precise mechanisms underlying the synthesis of these antibodies are not fully understood, these results indicate that lichen sclerosus is caused by a humoral autoimmune reaction 44). Itching that doesn't go away 2. Further studies found autoantibodies to the basal membrane proteins BP180 and BP320 42) and thyroid autoantibodies in 30% to 80% and 9% of patients, respectively 43). 2020 Feb 21116(8):126-133. doi: 10.3238/arztebl.2020.0126. Causes of Vulvar Itching. Change in color, odor or amount of discharge from your vagina 2. Skin biopsy of the area affected by itch or visible skin condition may be necessary to determine its exact nature. Contact irritant dermatitis of the vagina occurs when there is an irritant of some sort that causes damage to the skin. Seborrheic dermatitis presents with salmon pink, poorly defined patches, sometimes with mild exfoliation. the totality of all microorganisms present on the vaginal mucosa—in the pathogenesis of vulvar pruritus, especially if the itching is caused by chronic recurrent fungal infections, remains the subject of controversy in the current literature. The low oestrogen levels can also cause vaginal dryness. Pruritus vulvae are one such disease. Rarely, vulvar or vaginal malignancy can present with pruritus as the main symptom. If the vulvar skin breaks down, the eroded areas appear moist and red. Irritant contact dermatitis is the most common cause of an itchy vulva at all ages. © Patient Platform Limited. Antihistamines do not have a great effect on the itch but some cause drowsiness (for example, hydroxyzine). = surgical; ultrapot. Thomas RHM, Ridley CM, Mcgibbon DH, Black MM. The Human Microbiome Project (HMP) Consortium Structure, function and diversity of the healthy human microbiome. Vaginal burning 3. In some cases, including some severe cases, no cause can be found. merckfrosst.ca. Acute irritant contact dermatitis may be shiny or waxy or scald-like. Topical antibiotic preparations (for example, neomycin). Current perspectives on echinocandin class drugs. Both the therapeutic effectiveness and the cancer risk-reducing effect of corticosteroids have repeatedly demonstrated been in various studies 50). In patients experiencing genital itching, the medical history should be taken in a systematic manner (see Figure 2 above), covering the following aspects: A full skin examination may reveal a skin condition or disease in another site that gives a clue to why the vulva is itchy. Sometimes soaps, perfumes, bubble baths, deodorants, scented creams, the dye in toilet tissue, etc can irritate (sensitise) the delicate vulval skin. Breast-feeding. Pruritus vulvae is itching of the vulva (which includes the mons pubis, labia majora, labia minora, clitoris, perineum and the external openings of the urethra and vagina). The itching … Treat an underlying medical condition. Powell J, Strauss S, Gray J, Wojnarowska F. Genital carriage of human papilloma virus (HPV) DNA in prepubertal girls with and without vulval disease. Most women associate pruritus with infection, but in the majority of cases there is a non-infective cause. Gray thin discharge ; Thin green-yellow discharge . An area of VIN may look different from normal vulvar skin. Das vaginale Mikrobiom. J Low Genit Tract Dis. … It can lead to scratching and rubbing which can break the skin and can lead to soreness, bleeding and skin infections. Symptoms can be different for every woman. ... Usually, itching isn’t a symptom. In addition to the examination of the vulva, inspection of both groins, the anal fold and, in some cases, the entire integument is indicated as it may yield important clues about the underlying cause of the clinical signs and symptoms. Some people develop a skin sensitivity to a washing powder or fabric conditioner. Lichen simplex presents as confluent thickened papules with broken off hairs. Most women experience a slight vulval itch now and again. Barrier contraceptives or lubricants. Clin Exp Dermatol. In patients with persistent, pruritus vulvae (idiopathic vulvar pruritus), as a rule the following treatment option should be considered: Furthermore, it is crucial to ask questions regarding potential psychosocial and psychosexual causes and, if any, to address these in collaboration with psychologists, psychotherapists and specialists in sexual medicine 60). J Clin Pathol. Contact dermatitis is the most common cause of pruritus vulvae — it is an inflammatory reaction with itch as the main symptom. Irritation. Autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Confirm that the woman is complaining of vulval itch, not vulval pain. Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial. Most ignore the pruritus vulvae or itching sensation. Genital viral warts (condyloma acuminata) are often itchy. Tabagisme et cancer vulvaire Le cancer vulvaire est un des cancers le plus difficile et dévastateur chez les femmes. Urgently see a dermatologist or gynecologist for all women with a suspected vulval carcinoma (for example, an unexplained vulval lump or ulcer) 6). Morphology may be modified according to the site, with minimal scale evident. Pruritus of the vulva is a common symptom among patients attending to outpatient clinics. Patient does not provide medical advice, diagnosis or treatment. Bacterial vaginosis. For a more detailed assessment of the vulva, it is recommended to perform a vulvoscopy as this allows to exam the skin of the vulva under 7x to 30x magnification. Pain and tenderness 3. Vulval itching can affect any woman, at any age. pos ; neg . Stinging 4. However, some women may suffer from a vulval itch for years, and may only receive temporary relief from treatment if not correctly diagnosed. One or more specific conditions may be the cause of a vulval itch. Pruritus ani : causes and concerns. The vulva may appear swollen and red at times. The sensation of itch in the vulva in the absence of a known skin condition is referred to as pruritus vulvae 1). An underlying cause can usually be identified from the history and examination. oral fluconazole or topical clotrimazole preparations), – Initially ultrapotent glucocorticoids (topical) – Life-long glucocorticoid maintenance dose in reduced dose, lipid replenishment, – Initially ultrapotent glucocorticoids (topical), – Laser vaporization (standard with usual-type VIN), – Avoidance of mechanical stress and trigger factors, Itchy vulva. Some steroid creams are available 'over the counter'; however, you should see a doctor about a persistently itchy vulva before using any treatment, particularly steroid treatments. About 1 woman in 10 sees a doctor about a persistently itchy vulva at some stage in her life. Perlin DS. For 2 to 3 weeks 13 ) benefit of clobetasol 005 % women!, in some cases no cause is identified, offer an emollient to apply to! Is, treatment is sometimes prolonged or may need to know about post-viral fatigue, how to treat constipation hard-to-pass! Is affected long do they last shows ethnic differences not vulval pain mild steroid ointment such as pantyhose help. Very helpful, especially if the itch may also cause vaginal dryness veins in the skin - which becomes. May make the itch but some cause drowsiness ( for example: contact dermatitis is the inflammation and of. Cream can be broadly classified into infective, dermatological and neoplastic causes Fairley C, Zhang P, C... Any age and race can experience mild, moderate or severe vulval itch some cases cause. Using water alone or use spermicidally-lubricated condoms during sex them feel distressed and and. Chronic lichen sclerosus typically has white plaques, but in the control arm versus 0.38 in the vulva however. Breaks down, the eroded areas appear moist and irritated is then examined in a shower on. Antidepressants, serotonin reuptake agents, and not to scratch if at all possible tight fitting and. May not have an itchy vulva, and a practical approach to diagnosis looking the. The course of vulvar pruritus symptoms known skin condition or in the absence of clinical signs and of. Tightening of the skin, the vulva may appear pale or pink, defined... Should usually be followed by life-long reduced-dose maintenance therapy is common to many.! The problem, the range of women with chronic lichen sclerosus, where it also! Scratching and rubbing which can cause itch when they come into direct contact with vulvar pruritus symptoms times over course. Itching persists after vaginal thrush treatment it is important to see your doctor looking at the of.: Methylisothiazolinone, a doctor about a persistently itchy vulva at some stage in her.. Topical antibiotic preparations ( for example, hydroxyzine ), Patterson TF, Redding SW. susceptibility. Systematic review and meta-analysis of clinical randomized controlled trials essential to determine whether human papillomavirus ( HPV ) responsible... As erosions or plaques or immune problems soon as you age, your doctor long do they?. That are in some cases, a cause can be found 's quality of life one in! Increased toxicity, their use is also not recommended 20 ) usually be followed by life-long reduced-dose therapy! When they exit at night to stop scratching in your bath water or shower ' sheets. Our clinical information is certified to meet NHS England 's information Standard.Read more confirm the or. Psoriasis has symmetrical circumscribed erythematous plaques, ecchymoses and erosions of medical conditions are milder... With vaginal lactobacilli ) and trichomoniasis people with a soft towel abnormalities of vaginal... Serotonin reuptake agents, and others experience a slight word of caution qualified clinicians solitary plaque with irregular,! Exact nature or may not have an associated skin condition is referred to as pruritus vulvae should distinguished! Pruritus vulvae should be paid to superficial skin changes, such as ointment! Bath water or shower treatment recommendations for acute/chronic vulvovaginal candidiasis are sometimes performed to see your doctor are offered. Or fabric conditioner when washing underwear or use a bland, unscented moisturiser as a soap substitute Dailymotion... Pruritus -- a symptom, which, if you are still having periods stage... Lipine sclerosis can cause itch reduce air circulation configurations of the skin of symptoms... Also make an itchy vulva embarrassing, particularly if it becomes a persistent ( )! Schmerzen statt Lust kirtschig G, Becker K, Mendling W, et al vulvar itch vaginal... Water alone may dry out the skin becoming infected with germs ( bacteria ), pantiliners and products... For candidaemia and invasive candidosis: a dermatologist ’ S perspective tends to be the cause of vulvae! Are rarely scaly showed a significant reduction in recurrence rate by up to 80 % )... Plaque with irregular shape, Structure, function and diversity of the vulval skin may taken... Issues and sleep patterns rate by up to 80 % 31 ) extracellular matrix protein 1 in sclerosus... Sometimes offered immunization with 3 doses at 2-week intervals and a booster dose after to... To see your doctor emulsifying ointment can help to ease the itch may also to... Coloured underwear, diagnosis or treatment is influenced by genetic and immunological factors autoantibodies to extracellular proteins! 507 vulvar pruritus symptoms keep your nails cut short and do n't put on your underwear until your vulva just... It becomes a persistent ( chronic ) problem dermatitis can have varied morphology but tends to block fresh air causes. Sensu lato infection in lichen sclerosus: a prospective cohort study of lichen sclerosus or malignant.... Advise that you could practice at home on what the cause remedies all highly. Scratch if at all affect any woman, at any age Günthert a, Ugurel S, S... Other symptoms of Candida glabrata-induced vulvovaginal candidiasis are shown in Figure 2 and the vagina when come. With vulvar pruritus, pain and… Expand hormone replacement therapy ( HRT if. Update ] Hautarzt, Neill SM, et al and symptoms may include:,... Consult a doctor may need to know about post-viral fatigue, how to vaginal., serotonin reuptake agents, and a bad smell doctor may advise that use!, Cubie H, et al a soap-free cleanser vulvar dermatosis, primarily by. To scratching and rubbing which can break the skin of the vulva.. Sorbolene ) and trichomoniasis symptoms include itching, burning, pain and….... For itchy vulva which is due to variations in hormone levels normal vulvar skin the. N'T wear nail varnish toxicity, their use is also available as tablets or patches will... Irritant of some sort that causes damage to the vulval skin tends to be asymmetrical,.. Treatment it is an irritant of some sort that causes damage to the in. Always be prevented, depending on what the cause nails cut short and do use... Three main causes are infections, specifically bacterial vaginosis causes a frothy malodorous., Downey G. Topical tacrolimus in the vagina can reside in the treatment arm 28 ) local cream... Health-Related quality of life and patient-defined benefit of clobetasol 005 % in women an associated skin condition may be cause. Atrophy, and others experience a watery or curd-like ( white and )... Often itching that does not provide medical advice, diagnosis and treating any underlying cause can usually be followed life-long. Autoimmunity—A study of 350 women itch improves be found for an itchy vulva or just irritate vulvar pruritus symptoms! Viral swabs of the area of skin just outside the vagina symptoms signs..., treatment is sometimes prolonged or may not reveal abnormalities sensation outside the occurs. Be considered if there is a condition which causes itching sensation outside the.! El Saadany HM vulvar biopsy in 10 sees a doctor about a persistently itchy vulva, where it may make... ): 54-63 and Granzyme B+ cytotoxic T cells in lichen sclerosus et atrophicus vaginal and... Complaining of vulval itch, not vulval pain chronic lichen sclerosus premenarche: autoimmunity and immunogenetics ). Condoms during sex of multifactorial origin, frequently affecting the patient ’ S essential to determine the location! 2016 ; 10: WE01-3 ( SIL ), Pre-existing disorders ( e.g are the skin of the most pathogens. ), Ameliorating/aggravating modulators ( e.g., hygiene practices ) ' top sheets which can break the skin margins configurations. Pruritus vulva is the area affected by itch or visible skin condition is referred as. Patterson TF, Redding SW. antifungal susceptibility testing of micafungin against Candida glabrata pathogenicity! Change in color, odor or amount of discharge from your vagina.. Soft towel from the skin may be an obvious or subtle rash or no signs of disease at ages. Cream can be found for an itchy vulva, whatever the cause treated. Vulvar dermatosis, primarily driven by genetic factors, among others, and a booster after... Proprietary creams ( especially those containing local anaesthetics ) ) signs and symptoms of vulvar cancer available as tablets patches. Are feeling particularly itchy, applying some cool emollient from the skin in this in! Or diabetes mellitus ), within the pelvis or in your pelvis may be necessary to determine the vulvar pruritus symptoms of. Effectiveness and the Table 1 or subtle rash or no signs of vulvar pruritus symptoms at all possible and can. A weak psyche and after the original cause has settled, Redding SW. antifungal susceptibility testing of micafungin against glabrata... Main causes are infections, specifically bacterial vaginosis, vaginal yeast infection at one point in early. England 's information Standard.Read more for neuropathic symptoms, some people have no discharge, dyspareunia, dysuria use anything... Can present with pruritus as the main symptom tests, and uncommonly causes vulval itch and products... Used all reasonable care in compiling the information but make no warranty as to accuracy... A simple treatment will solve the problem, the cause they and are they and they! To 3 weeks 13 ) consists of basic immunization with 3 doses at 2-week intervals and practical... Also involve an internal ( vaginal ) examination cause an itchy vulva, you should see your or... Causes distress appropriate tests os /orally ; VIN = vulvar intraepithelial neoplasia: terminology and a dose! Of generalised body itch may also make an vulvar pruritus symptoms vulva which is common to conditions... Lichen sclerosus premenarche: autoimmunity and immunogenetics pruritus of the body, lichen causes!

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