LS Topical Treatment — SCE Dermatology MCQ
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Correct answer: A — Very potent (Clobetasol propionate 0.05%) — this is one of the rare indications for very potent topical corticosteroid on genital skin
Genital lichen sclerosus is one of the rare indications where very potent topical corticosteroid (Clobetasol propionate 0.05%) is specifically recommended for genital skin. This contrasts with most genital dermatoses where mild-moderate steroids are preferred. The BAD LS guidelines recommend Clobetasol propionate 0.05% ointment applied once daily for 4 weeks then alternate days for 4 weeks then twice weekly for 4 weeks (the 3-month induction regimen). Maintenance therapy (Clobetasol twice weekly or Mometasone furoate 0.1% as an alternative) prevents relapse. Patient education about self-monitoring for SCC (any persistent lump, ulcer, or change) is essential alongside topical treatment.
Reference: BAD 2018 LS Guidelines