Established erosive vulvovaginal lichen planus is progressing to adhesions and vaginal narrowing despite correctly used ultrapotent topical

Question

Established erosive vulvovaginal lichen planus is progressing to adhesions and vaginal narrowing despite correctly used ultrapotent topical corticosteroid. What is the most appropriate next step?

Accepted Answer

Escalate care through a specialist vulval multidisciplinary service

Answer

Use vaginal oestrogen alone to suppress the interface inflammation

Answer

Use repeated empirical fluconazole as disease-modifying treatment

Answer

Continue the unchanged topical regimen without re-examination

Answer

Ablate all active erosions with carbon-dioxide laser

Erosive Lichen Planus — SCE Dermatology MCQ

Established erosive vulvovaginal lichen planus is progressing to adhesions and vaginal narrowing despite correctly used ultrapotent topical corticosteroid. What is the most appropriate next step?