Atrophic sclerosing moss is a chronic condition that affects the female vulva. It typically presents as pale white or ivory-white atrophic sclerosing patches with well-defined borders and scattered small papules with narrowing of the vaginal opening. Conscious symptoms are mainly intense itching and sometimes burning pain. It is a rare skin disease of unknown etiology, mostly seen in women and middle-aged people, and is easily misdiagnosed as vaginitis and delayed.
I. Etiology
The etiology is unknown, but it is common in women, especially in menopausal women. The damage is usually found in the anus, external genitalia, neck, chest and trunk.
Clinical symptoms
It occurs mostly in older women after menopause, but also in young girls aged 2-6 years. In women, the lesions are usually found on the female genital area and around the anus. The skin lesions are white or ivory white. They begin as rice-grain-sized spots, scattered or clustered. They are not hard at this time, but when they fuse into patches, the skin becomes hard and inelastic. In females, it occurs in the female genital area and the anus, and is a less clear-cut ivory-white spot with a dumbbell-shaped distribution. Squamous cell carcinoma may occur in about 10% of cases.
Treatment plan
Women should supplement some estrogen after menopause. For those who have already developed the disease, girls can use 2%-3% testosterone propionate cream topically. In menopausal women with intense itching, the disease is easily misdiagnosed as female genital leukoplakia, and intra-lesion injection with deferiprone acetate is effective, but the dosage should be smaller and the interval should be longer.
1.Eliminate the causative factors
For those with diabetes, trichomonas or mycotic vaginitis, etc., treatment should be carried out. Keep the vulva clean, avoid scrubbing with soap, scratching and using irritating drugs. Take multivitamins and sedative and desensitizer.
2.Local medication
To stop itching, anti-inflammatory, emollient and improve local nutrition.
(1) Topical lotion
Chinese herbal medicine bitter ginseng lotion or other Chinese herbal medicine water decoction fumigation.
(2) For atrophic type
Use 1~2 testosterone propionate cod liver oil cream (100~200mg of propionate, added in 20 cod liver oil ointment 10~20g) for external rubbing, 3~4 times/day, for 2~3 months, which can make the skin thicken and soften, and loosen the adhesions.
(3) For hyperplastic type and mixed type, dexamethasone and hydrocortisone ointment can be used. For mixed type, topical rubbing with testosterone propionate cod liver oil cream is also required.
3.Laser treatment
Laser treatment of sclerosing mossy dystrophy has the effect of stopping itching, promoting the healing of ulcerated wounds and improving local blood flow.
4.Surgical treatment
Moderate or severe atypical hyperplasia, or ulcers and chaps that do not heal after non-surgical treatment, surgery can be considered.