OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is lichen sclerosus. While this may seem a odd practice, it is useful to see multiple examples of how lichen sclerosus will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 69 year old woman come stoeckled the office with very “intense” vulvar itching and burning. She explains that she has been having these symptoms for the past 7 months and has noticed that the burning is worse at night. She has tried over the counter topical lubricants but they have not helped. She is no longer active sexually, simply because penetration is very painful. Her past medical history is notable for type 1 diabetes that has been controlled with insulin. Physical examination shows dry, white, plaque-like vluvlar skin with the loss of the labia minor. The physician notes clitoral hood retraction. Excoriations are noted bilaterally on the vulva. What is the most likely diagnosis?
Explanation: white “cigarette paper” skin on vulva + retraction of clitoris = lichen sclerosus
Question # 2
A 66 year old G1P1 woman comes to the clinic complaining of vulvar pruritus for the past year. She has tried multiple over-the-counter topical therapies without any change. She has no significant vaginal discharge. She has severe dyspareunia at the introitus and has stopped having intercourse as a result. Her past medical history is remarkable for allergic rhinitis and hypertension. A gynecological examination reveals loss of the labia minora with resorption of the clitoris (phimosis). The vulvar skin is thin and pale. No ulcerations are present. The vagina is mildly atrophic, but appears uninvolved. What is the likely diagnosis in this patient?
Explanation: white “cigarette paper” skin on vulva + retraction of clitoris = lichen sclerosus
Page Updated: 10.05.2016