Vulval lichen sclerosus — DRCOG MCQ
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Correct answer: D — Vulval lichen sclerosus
Vulval lichen sclerosus is the best answer because the vignette is testing Vulval lichen sclerosus and the recommended approach is consistent with BASHH guideline; BAD guideline. The other diagnoses do not explain the combination of timing, examination findings and investigation results as well as the correct diagnosis. Specifically, Pelvic inflammatory disease; Placenta praevia; Chlamydia infection; Stress urinary incontinence would be suboptimal in this scenario. The key discriminator is the pattern across symptoms, examination and timing, not a single isolated symptom.
Reference: BASHH guideline; BAD guideline