A 27-year-old woman presents to the GP with a 1-year history of pruritus vulvae. She has tried antifungal treatment, topical corticosteroids, and emol...

Question

A 27-year-old woman presents to the GP with a 1-year history of pruritus vulvae. She has tried antifungal treatment, topical corticosteroids, and emollients without lasting improvement. Vaginal swabs are negative for infection. Examination shows mild erythema but no white patches, ulceration, or suspicious lesions. She is distressed. Which is the single most appropriate next step?

Accepted Answer

Take a vulval biopsy to exclude an underlying dermatological condition before further empirical treatment

Answer

Prescribe a stronger topical corticosteroid

Answer

Reassure and discharge

Answer

Prescribe oral fluconazole for 6 months

Answer

Refer to psychology

uk-drcog MCQ (SBA): Persistent Pruritus Vulvae - Biopsy Indication