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Vulval Dermatology. Update from British Society for Study of Vulval Diseases Meeting Cardiff 2008. BSSVD. Relief of patients suffering from vulval disease Promotion of research into causes of vulval disease Practice and art and science of diagnosis and treatment of vulval diseases
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Vulval Dermatology Update from British Society for Study of Vulval Diseases Meeting Cardiff 2008
BSSVD • Relief of patients suffering from vulval disease • Promotion of research into causes of vulval disease • Practice and art and science of diagnosis and treatment of vulval diseases • www.bssvd.org
Cardiff 2008 • Current Challenges in Vulval disease • Prospective Study to Determine Factors Leading to Delayed presentation of Patients with Vulval Lichen Sclerosis AJ Mehta et al University Hospital Wales
Background • LS is chronic ,inflammatory condition • Most commonly affects post-menopausal women but occurs at all ages • Significant morbidity due to chronicity, scarring,psychosexual problems and SCC risk
Prospective study of 28 post menopausal patients with LS in dermatology OPD
Results • Mean duration of symptoms 99 months • Most common symptom itching in 96% • Burning on micturition in 50% • 50% tried OTC treatments before seeing GP
Results • 60% waited >3/12 to report symptoms • 21% waited 4-6/12 • 14% 7-12/12 • 25%>12/12
Why did they wait? • 42% patients thought symptoms were “normal for their age” • 21% too embarrassed • 71% pts would prefer female Dr • Other reasons:other health problems or family members took precedence
76% patients examined by GP • 32% given definite diagnosis (7% candida) • Of those pts with no definite diagnosis • 25% referred immediately to dermatology • 25% ref after 1-3/12 • 14% ref after 4-6/12 • 11% ref after7-12/12
Conclusions • Increased patient awareness required • Vulval Health Awareness Campaign • www.vhac.org • Education re self examination • Increased clinician awareness
Information Resources for Patients and Dr’s • www.vahc.org • www.bssvd.org • www.vulvalpainsociety.org • www.lichensclerosus.org • www.UKLP.org.uk • www.bashh
Clinical snippets • Vulval ulceration secondary to nicorandil • May occur in pts on long standing treatment and after dosage increase
Clinical Snippets • Increased auto-immunity in association with Lichen sclerosus and erosive Lichen planus • Thyroid disease most common (15% pts) • Coeliac disease associated with erosive LP