WOMENS-HEALTH Messages for July, 2000: Re: 7 months of Labial burning/redness

Re: 7 months of Labial burning/redness

From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Wed, 5 Jul 2000 16:30:20 -0500 (CDT)

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In reply to: K.: "7 months of Labial burning/redness"

At Wed, 5 Jul 2000, K. wrote: >
>I am a 34 year old woman with a 7 month history of redness and burning
>of the labia; specifically the folds between the labia minora and majora
>bilaterally. There is also some "bumpiness" to the area. Viral
>cultures were negative, bacterial cultures showed heavy growth of e.coli
>and light growth enterococcus which my physician determined was normal
>(I did, however, try penicillin and augmentin). My biopsy showed "focal
>squamous epithelial hyperplasia with mild hyperkeratosis, negative for
>malignancy and dysplasia". Besides the above antibiotics, I have also
>tried numerous steriod creams and antifungals with no relief. What's
>odd is that some days the burning is severe and some days I hardly feel
>it, although the redness/bumpiness is always there. My physician has
>spoken with pathologists, dermatologists, and other ob/gyn's and have
>come up with two therapies to try. First, diflucan q 3 days for 5
>weeks, which I am now trying (it seems to be getting worse). The other
>alternative if the above does not work is trying elavil (for some kind
>of neuralgia?) Intercourse is not painful, and the area around the
>vulva/vaginal opening is not affected, therefore I believe I can rule
>out vulvar vestibulitis. Please send me your thoughts and/or referrals
>on who I could contact in this field who could provide with with some
>insight to this most unusual problem. Thank you and I look forward to
>hearing from someone.

K., I have a few thoughts. First, I would want to assure that there is not human papilloma virus present (HPV). This should have been detected on the biopsy, but can also be seen using a special scope and staining the area with dilute acetic acid. Based on the biopsy demonstrating hyperplasia, the steroid cream should have worked. I would want to make sure that there isn't something like lichen sclerosis. Finally, I using the Elavil is a good idea and I would certainly try this. I have seen good success after all other pathology has been ruled out... Lynn

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana

**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.

**Thank you for your understanding ;-)

Next message: Becky: "Abnormal bleeding?"
Previous message: Lynn D. Montgomery, MD: "Re: Switching from Triphasil 28 to Nordette"
In reply to: K.: "7 months of Labial burning/redness"

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