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Dermatology · Papulosquamous disorders: lichen sclerosus
Sample itemA postmenopausal woman has intense vulval itching with porcelain-white atrophic plaques in a figure-of-eight around the vulva and anus. What is the first-line treatment?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Ultrapotent topical corticosteroid such as clobetasol
Lichen sclerosus is a chronic inflammatory disease with a small risk of squamous cell carcinoma, and clobetasol propionate 0.05 percent is the first-line treatment with long-term follow-up. In men, it causes balanitis xerotica obliterans.
Option by option
A. Topical antibiotics
Antibiotics are not indicated without infection.
B. Oral griseofulvin
Griseofulvin treats dermatophyte infection.
C. Ultrapotent topical corticosteroid such as clobetasol (correct)
Correct. Ultrapotent topical steroids control disease.
D. Topical estrogen alone
Estrogen alone does not treat the condition.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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