Lichen Simplex Research Articles

Perianal Lichen Simplex Chronicus: A Case Report and Literature Review

Abstract Background: Lichen simplex chronicus (LSC) is an eczematous disease caused by cell-mediated autoimmune inflammation that presents as an erythematous and distressingly pruritic area that develops into a thickened, indurated, and atrophic area. U.S. prevalence is ∼0.5% and most commonly involves the labia minora. Often, an itch–scratch–itch cycle perpetuates this condition. Scratching causes intense pleasure, which could lead to excoriation, lichenification, depigmentation, and chronic dermatitis. Itching may be intensified at night. Common triggers are sweating, stress, walking, irritation from clothing and panty-liner–based infections. Case: A 22-year-old nulligravida presented in a clinic for emergency room follow-up with a diagnosis of an ovarian cyst and pyelonephritis that were treated with proper antibiotics. A wet mount was diagnostic for bacterial vaginosis, so the patient was treated with the indicated antibiotic and was scheduled for follow-up at 1 month. After multiple months of treatme...

Protective Effect of Botulinum Toxin Type A Against Atopic Dermatitis–Like Skin Lesions in NC/Nga Mice

Botulinum neurotoxin (BTX) A possesses various biological activities, including anti-inflammatory and antipruritic actions. Human and animal studies have shown that BTX is effective in treating histamine-induced itch, lichen simplex chronicus, psoriasis, rosacea, allergic rhinitis, and scar prevention. However, its effect on atopic dermatitis (AD) has not been studied yet. To examine the effect of BTX on AD using a mouse model. The primary outcome was skin thickness and transepidermal water loss (TEWL), and the secondary outcome was the alteration in skin severity scores, histological, and laboratory test results. Forty-two NC/Nga mice (a mouse model for AD) were allocated into 6 groups (the untreated, 2-Chloro-1,3,5-trinitrobenzene [TNCB] alone, TNCB + BTX 30 U/kg, TNCB + BTX 60 U/kg, TNCB + vehicle [0.9% saline], TNCB + 0.03% tacrolimus). Those of the BTX group received intradermal injections of BTX on the rostral back once on the day of TNCB sensitization. The effect of BTX in TNCB-treated NC/Nga mice was assessed by measuring skin thickness, TEWL (primary outcome), the skin severity scores, histological changes of test skin including mast cell count, interleukin (IL)-4 mRNA and protein expression, and total serum IgE (secondary outcome). A single intradermal injection of BTX significantly suppressed skin thickness and TEWL in the TNCB-applied skin. The clinical severity scores, acanthosis and mast cell infiltration, were less in the BTX groups. BTX injection also inhibited TNCB-induced increase in IL-4 mRNA and protein expression in mice, but its effect on serum IgE level was not significant. The preliminary results suggest that BTX may be a novel approach to the prevention and supplemental treatment of acute AD lesions.

Pattern of geriatric dermatoses at a tertiary care center in North-East India

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The aging population is dramatically increasing with the increase in the average life. It is faced with different health problems which include skin as well. The aim was to study the clinical pattern of geriatric dermatoses and associated systemic diseases.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A cross-sectional study was conducted for a period of 18 months to study the pattern of geriatric dermatoses on 250 geriatric patients aged above 60 years attending Dermatology OPD, RIMS, Imphal</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 250 patients 136 were males and 114 were females. The mean age was 67.28 years and the male to female ratio was 1.19:1. Majority of the patients belonged to the 60-69 age group (66%). 63.2% had the dermatosis for more than 1 month before presentation. The most common dermatoses were: infections (26.4%), eczemas (22.4%), papulosquamous (10.4%), photodermatoses (8.0%) and infestations (6.8%). Herpes zoster (13.2%) and superficial fungal infections (7.6%) was the most common infections. Lichen simplex chronicus (6%). was the main form of eczema. Psoriasis (6%) and lichen planus (4.4%) were the common papulosquamous disorders. Chronic actinic dermatitis (6%) represented as the main pattern of photodermatoses. Uncommon disorders were tumors (4%), immunobullous (2.6%), drug reaction (2.4%), vitiligo (2%) and alopecia areata (0.8%).</span><span lang="EN-IN"> Main co-morbid systemic diseases were hypertension (16.4%) and diabetes mellitus (6.8%). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Different disease entities in the elderly demands different approach to management. Contributing factors like neglect, delay in seeking treatment, co-morbidities have to be properly addressed. Health education on proper skin care, avoidance of irritants and self-medication etc would help reduce the incidence of common dermatoses.</span></p>

Hypertrophic Lichen Planus versus Well-Differentiated Squamous Cell Carcinoma: A Histological Challenge

Differentiating hypertrophic lichen planus (LP) from well-differentiated squamous cell carcinoma (SCC) is a histological challenge given the numerous histopathologic similarities between SCC and pseudoepitheliomatous hyperplasia (PEH) arising in the setting of hypertrophic LP. Multiple reports have shown that SCC can arise from hypertrophic LP not infrequently, but that the LP-to-SCC sequence is poorly understood, and many cases defy diagnosis due to histologic similarities. However, there are several clinical clues and histopathologic details that have shown to have some value when trying to ascertain the correct diagnosis. To the contrary, immunohistochemical tests have shown little promise in differentiating hypertrophic LP from SCC. Although multiplex PCR has shown some potential in differentiating PEH from SCC, this has only been in the setting of patients diagnosed with prurigo and lichen simplex chronicus, but not necessarily in the case hypertrophic LP.

Hypertrophic Lichen Planus versus Well-Differentiated Squamous Cell Carcinoma: A Histological Challenge

Differentiating hypertrophic lichen planus (LP) from well-differentiated squamous cell carcinoma (SCC) is a histological challenge given the numerous histopathologic similarities between SCC and pseudoepitheliomatous hyperplasia (PEH) arising in the setting of hypertrophic LP. Multiple reports have shown that SCC can arise from hypertrophic LP not infrequently, but that the LP-to-SCC sequence is poorly understood, and many cases defy diagnosis due to histologic similarities. However, there are several clinical clues and histopathologic details that have shown to have some value when trying to ascertain the correct diagnosis. To the contrary, immunohistochemical tests have shown little promise in differentiating hypertrophic LP from SCC. Although multiplex PCR has shown some potential in differentiating PEH from SCC, this has only been in the setting of patients diagnosed with prurigo and lichen simplex chronicus, but not necessarily in the case hypertrophic LP.

A study of pattern of nonvenereal genital dermatoses of male attending skin OPD of tertiary centre in Kalaburagi

<p class="abstract"><strong>Background:</strong> Dermatoses involving genital areas are not always sexually transmitted. The diseases, which are not sexually transmitted, are referred as nonvenereal dermatoses. These disorders are the cause of considerable concern to patients causing mental distress and guilt feeling in them. Nonvenereal dermatoses are quiet often a diagnostic dilemma to the treating physician also. The aim was to determine clinical and epidemiological pattern of nonvenereal dermatoses of male external genitalia.</p><p class="abstract"><strong>Methods:</strong> This was a descriptive study of 50 consecutive male patients over age of 18 years, with genital lesions of nonvenereal origin, attending the skin outpatient department of BTGH, Kalaburagi. Study was done for a period of 6 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study included 50 male patients with nonvenereal genital lesions. A total of 14 nonvenereal genital dermatoses were noted. The most common nonvenereal genital dermatoses were vitiligo (20%), fixed drug eruptions (16%), scabies (14%), pearly penile papule (10%), and dermatophytoses (10%). Other dermatoses included psoriasis, plasma cell balanitis or Zoon's balanitis, lichen simplex chronicus, lymphangioma circumscriptum, squamous cell carcinoma, scrotal dermatitis, lichen planus, steatocystoma multiplex and candidiasis.</p><strong>Conclusions:</strong>This study helps in understanding the etiological causes of nonvenereal genital dermatoses and their pattern in this region.<p> </p>

Short- and long-term efficacy of focused ultrasound therapy for non-neoplastic epithelial disorders of the vulva.

To investigate the short- and long-term efficacy and influential factors of focused ultrasound for the treatment of non-neoplastic epithelial disorders of the vulva (NNEDV). A retrospective observational study. A gynaecologic department in a single centre in China. Patients with NNEDV were included in this study: 85 patients were diagnosed with lichen simplex chronicus (LSC), 44 patients with vulva lichen sclerosus (VLS), and seven patients with lichen planus (LP). A total of 136 eligible patients with NNEDV were treated with focused ultrasound. After the treatment, based on changes in the degree of symptom severity and local skin signs (lesion size, skin colour and elasticity) before and after treatment, the treatment effectiveness for each patient was assessed. We further analysed the relations among pathologic type, age, course and curative rate. Statistical analysis was performed using the Chi-square (McNemar) test. Improvement in the symptoms and physical signs and the predictive factors. Symptom relief was observed in all patients. The appearance and colour of the vulva returned to normal after the ultrasound treatment. Complete remission (CR) occurred in 68 of 136 (50%) patients (41 patients with LSC and 12 patients with VLS). The response rate was 93.38% (127/136). Seven patients who had a poor response to the first session of treatment were treated again with ultrasound therapy and a good response was observed. No severe complications were observed. There was no significant difference in treatment results among the different pathological types (P>0.05). However, the course of the disease and the age of the patients were related to the treatment results (P<0.05). NNEDV can be treated with focused ultrasound effectively and safely. The course of the disease and the age of the patients may be predictive factors. Patients with non-neoplastic epithelial disorders of the vulva can be safely and effectively treated with focused ultrasound. No significant difference in treatment results was observed between the different types of non-neoplastic epithelial disorders of the vulva.

Lichen Simplex Chronicus as an Essential Part of the Dermatologic Masquerade

A 48 years old female patient had been suffering from the lesions presented for four years. They have started as small, pruritic patches which had been mechanically irritated and grew up in time. The patient had no associated comorbidities or allergies, and she was not under any medication. On physical examination, she presented one erythematous, exudative plaque, with dimensions of 2.5/4 cm, located on the proximal phalanx and interphalangeal articulation of the left thumb. All histopathological features were consistent with the diagnosis of lichen simplex chronicus. Some lesions of lichen simplex chronicus exhibit signs of pseudocarcinomatous, infundibular and sometimes eccrine ductal proliferation of keratinocytes. Although the pseudoinfiltrative aspect of the epithelial proliferation and its pronounced degree might mimic a well-differentiated lesion of squamous cell carcinoma, a lack of cellular atypia and atypical mitotic figures are features that do not support this diagnosis. On the other hand, long lasting lesions of lichen simplex chronicus may lead to alterations in the processes of keratinocyte proliferation and differentiation and eventually give rise to malignant transformation. The best treatment management is a psychodermatological approach, a combination of skin care with psychotherapy, in order to prevent relapses.

Pattern of skin diseases among workers in ship-breaking yards in Bangladesh

Dealing with different toxic chemical and physical agents in ship scrapping activities of ship breaking workers make them vulnerable to suffer from different occupational health hazards including skin diseases. this cross sectional study was carried out in Bangabandhu Sheikh Mujib Medical University, Dhaka and a temporary health center established near the ship-breaking yards of Shitakunda, Chittagong to describe the frequency and pattern of skin diseases among ship-breaking workers in Bangladesh. Five hundred workers of ship breaking yards were included consecutively, history was taken and examined to diagnose skin diseases. Physical examination and laboratory tests (patch test, prick test, woods lamp test, microscopy and histopathology) were done where needed. Most (69.2%) of the workers were from the age group 15 to 62 years and 27.8% were &lt;18 years. Only 27 (5.4%) had some sorts of training and 24.8% do not use any type of protective measure. At least one form of skin disease was found in 47.8% workers. Types of skin diseases were contact dermatitis (19.4%), scabies (15.8%), accidental cut/burn/scald (15.6%), fungal infection (dermatophytosis / pityriasis versicolor/ candidiasis) (10.6%), impetigo / pyoderma (9.8%), seborrheic dermatitis (9.6%), acne 7.2%, palmoplantar keratoderma 4.8%, glossitis/stomatitis/ chelitis 4.4%, lichen simplex chronicus 3.4%, urticaria 2.4% and psoriasis 1.2%. Contact dermatitis, scabies, accidental cut/burn/scald, fungal infections, impetigo/pyoderma, seborrheic dermatitis and acne are the common skin diseases among ship breaking workers. Ensuring adequate protective measures, awareness and training can control these skin diseases among ship-breaking workers.Bangladesh Med J. 2016 Sep; 45 (3): 147-150

Perianal Dermatitis.

Perianal complaints are often consulted in dermatology clinics, and in many cases, a conclusive diagnosis is not easily made. The aim of this study was to study and identify the epidemiological, clinical, and contact allergy features of patients with perianal dermatitis who attended at a contact dermatitis unit in a tertiary hospital in Spain. Adult patients with long-lasting (>4 weeks) perianal dermatitis were recruited during the past 10 years for investigation and follow-up. Every patient underwent a diagnostic workup consisting of dermatological exploration and patch tests with the standard and specific series, as well as the patients' own products. General surgical exploration was also performed in some patients. One hundred twenty-four patients were included. The MOAHLFA index was as follows: 43.5, 0, 4.8, 11.3, 1.6, 8.1, and 75. The main final diagnoses were allergic contact dermatitis (32.3%), psoriasis (24.2%), irritant contact dermatitis (17.7%), and lichen simplex (neurodermatitis) (10%). Eighty-one patients (66.1%) showed 1 or more positive reactions, and in 52 patients (43%), positive reactions relevant to the present disease were found. Contact allergy in patients with long-lasting perianal complaints is frequent. It is mandatory for these patients to be referred to a dermatologist for an adequate evaluation and patch testing. Methylchloroisothiazolinone/methylisothiazolinone seems as the most common allergen implicated in perianal contact dermatitis.

Acquired elastotic hemangioma-like changes and eccrine sweat duct squamous metaplasia in lichen simplex chronicus/prurigo nodularis-like lesions of the knee and elbow.

The so-called acquired elastotic hemangioma (AEH) represents a peculiar vascular lesion affecting the sun-damaged skin of the extensor surface of the forearms or the lateral aspect of the neck of middle-aged or elderly women. This is a clinicopathological and immunohistochemical study of a series of 6 lesions located on the knee or elbow showing epithelial features of lichen simplex chronicus (LSC)/prurigo nodularis (PN) with a marked subepidermal vascular proliferation closely resembling AEH. Microscopically, all cases of cutaneous lesions showed epithelial features of LSC/PN, that is compact hyperkeratosis with focal parakeratosis, irregular acanthosis, prominent hypergranulosis. Moreover, a marked subepidermal vascular proliferation arranged in a horizontal band closely resembling AEH was detected in these lesions. Another common histopathological finding was eccrine duct squamous metaplasia and/or hyperplasia. While AEH represents a distinctive clinicopathological variant of hemangioma characteristically appearing on sun-exposed areas of middle-aged or elderly patients, the herein described lesions seem to be non-neoplastic epithelial, vascular and eccrine sweat duct reactive changes which are likely to be associated with chronic pressure or repeated mechanical stimulation with a marked predilection for the knee and elbow.

Assessment of CK17 as a Marker for the Diagnosis of Differentiated Vulvar Intraepithelial Neoplasia.

Differentiated vulvar intraepithelial neoplasia (dVIN), precursor of vulvar squamous cell carcinoma, is human papilloma virus independent and often found in a background of lichen sclerosus (LS) and lichen simplex chronicus (LSC). Subtle histologic findings make the diagnosis of dVIN difficult, and, although the use of p53 and Ki-67 has been of some value, there is a need for a better immunohistochemical marker. Cytokeratin 17 (CK17), a cytoskeletal intermediate filament protein, has previously been used in the diagnosis of anogenital lesions. Here we evaluated CK17 in dVIN in comparison with LS, LSC, and usual VIN (uVIN/HSIL). Twenty-nine cases of dVIN, 9 cases of uVIN, 8 cases of LS, and 7 of LSC were evaluated using CK17, Ki-67, and p53. All 29 dVIN cases displayed immunoreactivity for CK17, with 27 (93%) showing intermediate to strong and diffuse reactivity. No cases of uVIN displayed diffuse CK17 expression, whereas 63% of LS and 29% of LSC displayed intermediate to strong diffuse immunoreactivity, confined to the upper half of the epithelium. P53 and Ki-67 expression was present in varying degrees in all types of lesions, displaying limited discriminatory power for dVIN. Our findings suggest that CK17, although not specific for dVIN, when combined with histologic findings, Ki-67, and p53 immunohistochemistry, can be a marker of vulvar dysplasia and serve as an adjunct in the diagnosis of dVIN. Specifically, in small biopsies, the presence of diffuse suprabasal or full thickness expression strongly favors a diagnosis of dVIN over LSC, whereas focal and/or superficial expression supports a diagnosis of LSC.

Differences Between Men and Women in Chronic Scratching: A Psychodermatologic Study in Lichen Simplex Chronicus

IntroductionChronic scratching is common to many skin disorders. Being a female and presenting a high level of psychopathology are risk factors for chronic scratching. Yet, it is unclear why. Certain personality characteristics that are more prevalent in women are also known to influence emotional states (i.e. emotional tension). ObjectiveThe present study aims to explore whether these personality styles might help understand why gender and emotional distress are associated with scratching. Material and methodsWe compared the personality patterns of 103 patients (69.9% women) diagnosed with Lichen Simplex Chronicus, against a sample of healthy individuals. ResultsSignificant differences were found in the personality styles of men and women with LSC. Women were more pessimistic, oriented to fulfil the needs of others, traditional, insecure, submissive, and reserved, with moderate (d=.43) to strong (d=.96) size effects ranges. Some of these differences, such as in traditionalism, dutifulness, other-orientation, and pessimism, were also observed when compared with healthy men and women, with small (d=.03) to moderate (d=.47) size effects ranges. ConclusionsThese psychological factors may help explain the mechanisms underlying gender differences in chronic scratching, at least in Lichen Simplex Chronicus. The findings might open new avenues for research and treatment.

Lichenoid vulvar disease: A review.

Vulvar dermatoses are common, potentially debilitating conditions that can be seen by a variety of medical specialists. Lichenoid vulvar diseases, namely lichen sclerosus (LS), lichen planus (LP), and lichen simplex chronicus (LSC), can all negatively impact patients’ quality of life and LS and LP also have an association with squamous cell carcinoma. It is essential that dermatologists are familiar with the unique features of each of these conditions to ensure the appropriate management and follow up. Herein, we provide an update on the epidemiology, clinical presentation, histopathology, and treatment of patients with vulvar LS, LP, and LSC.

Differentiated exophytic vulvar intraepithelial lesions are genetically distinct from keratinizing squamous cell carcinomas and contain mutations in PIK3CA

Human papillomavirus-negative keratinizing vulvar cancers typically harbor TP53 mutations as do their precursors, differentiated vulvar intraepithelial neoplasia. However, atypical verruciform proliferations are also associated with these malignancies and their pathogenesis is poorly understood. This study compared 11 atypical verruciform lesions, including atypical verruciform hyperplasia, vulvar acanthosis with altered differentiation, and verruciform lichen simplex chronicus, with 14 human papillomavirus-negative keratinizing squamous cell carcinomas. Extracted tissue DNA was subjected to targeted massively parallel sequencing of the exonic regions of 300 genes. Eight (73%) and six (55%) of eleven atypical verruciform lesions contained mutations in PIK3CA and ARID2, respectively. No TP53 mutations were identified. Eleven (79%) and five (36%) of fourteen keratinizing squamous cell carcinomas tested contained TP53 and CDKN2A mutations, respectively. Keratinizing squamous cell carcinomas displayed the majority of copy number variations with some variations (7p gain and 8p loss) shared by some cases in both groups. One patient developed atypical verruciform lesions with PIK3CA mutations followed by a keratinizing carcinoma with mutations in both PIK3CA and TP53. This study, for the first time segregates atypical verruciform lesions by virtue of a unique genotype (PIK3CA mutant/TP53 wild type) illustrating an example of progression to a TP53-mutated keratinizing carcinoma. The findings indicate that although PIK3CA mutations are found in <10% of vulvar squamous cell carcinomas, they may be specific for a particular pathway involving atypical verruciform lesions, which could function as either a direct precursor or a risk factor for vulvar squamous cell carcinoma. Given the presence of a molecular signature, we propose the term ‘differentiated exophytic vulvar intraepithelial lesion’ for this group. Whether they function as direct precursors to a less common form of squamous cell carcinoma will require further study, but carcinomas associated with these lesions might warrant testing for PIK3CA mutations to address this question.

Differences Between Men and Women in Chronic Scratching: A Psychodermatologic Study in Lichen Simplex Chronicus

IntroductionChronic scratching is common to many skin disorders. Being a female and presenting a high level of psychopathology are risk factors for chronic scratching. Yet, it is unclear why. Certain personality characteristics that are more prevalent in women are also known to influence emotional states (i.e. emotional tension). ObjectiveThe present study aims to explore whether these personality styles might help understand why gender and emotional distress are associated with scratching. Material and methodsWe compared the personality patterns of 103 patients (69.9% women) diagnosed with Lichen Simplex Chronicus, against a sample of healthy individuals. ResultsSignificant differences were found in the personality styles of men and women with LSC. Women were more pessimistic, oriented to fulfil the needs of others, traditional, insecure, submissive, and reserved, with moderate (d=.43) to strong (d=.96) size effects ranges. Some of these differences, such as in traditionalism, dutifulness, other-orientation, and pessimism, were also observed when compared with healthy men and women, with small (d=.03) to moderate (d=.47) size effects ranges. ConclusionsThese psychological factors may help explain the mechanisms underlying gender differences in chronic scratching, at least in Lichen Simplex Chronicus. The findings might open new avenues for research and treatment.

Multinucleated Atypia of the Vulva: A Mimic of Human Papillomavirus Infection

Background: An uncommon finding is the presence of multinucleated cells in the squamous epithelium of the vulva, unrelated to human papillomavirus (HPV) infection. Most likely a result of inflammation, these cells have been seen within the basal-to-middle layers of the squamous epithelium. This finding can be mistaken for evidence of HPV infection. Case: This article describes the case of a woman in her 30s who presented with chronic vulvar pruritus and whose condition remained unresponsive to multiple rounds of anticandidal therapy. Results: Vulvar biopsy showed multinucleated atypia in a setting of squamous-cell hyperplasia (lichen simplex chronicus). Conclusions: A pitfall to avoid is classifying these multinucleated cells as evidence of HPV infection. (J GYNECOL SURG 33:41)

Dissociation and conversion symptoms in dermatology

Dissociation and conversion (defined as the somatic component of dissociation) can play an important mediating role in the exacerbation of the stress-reactive dermatoses (eg, psoriasis, idiopathic urticaria, atopic dermatitis), dermatoses that are exacerbated by excessive scratching (eg, lichen simplex chronicus, prurigo nodularis) and koebnerization, and the self-induced dermatoses (dermatitis artefacta, acne excoriée, skin picking disorder, trichotillomania, onychotillomania/onychophagia). Dissociative symptoms often coexist with obsessive-compulsive symptoms in the more severe cases of the self-induced dermatoses.Dissociation can play an important role in cutaneous sensory disorder (eg, scalp dysesthesia syndrome, stomatodynia/glossodynia, vulvodynia/scrotodynia, medically unexplained anesthesia). Dissociation typically occurs in the context of extreme psychosocial stress and a history of severe abuse/neglect during early life. Dissociative patients may experience a sense of detachment from their body and present in a state of extreme self-neglect, including denial of serious skin disorders. Amnesia is one of the core symptoms of dissociation; therefore, patients, who self-induce their skin lesions during a dissociative episode often deny self-inducing their lesions; it is important to recognize that this is distinct from malingering, and the lesions are not intentionally induced. Dissociation and conversion symptoms are typically present in the complex dermatology patient and should be assessed using a comprehensive biopsychosocial approach.

Study of pruritus vulvae in geriatric age group in tertiary hospital

Background:According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients.Methods:We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case.Results:Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus.Conclusion:Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance.

Study of pruritus vulvae in geriatric age group in tertiary hospital.

According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients. We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case. Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus. Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance.