Should I be worried

[worried2007]

Hello Doc I have had vulvar irritation for the past 5 months or so. I have been tested for herpes with type specific three times all neg and cult all neg. I recently saw a vulvar specialist who did a biopsy and diagnosed me with lichen simplex chronicus. During my period last week I started to have freq. urination, a slight burning when I went to the bathroom and a slight pain in my abdominal region. I went and got the AZO UTI pills to help with the discomfort till I saw the doc on Mon. They took a urine sample and gave me some cipro 500mg 1 per day 4 a week.  The reason I am concerned is because I also had some slight redness on my the inside of my vulvar where the clitoris and urethral opening is.  I asked the doctor and she said it was the LSC.  That is turns the skin white on the external vulvar skin and red on the internal vuvlar skin.  Since starting the cipro,the burning when I pee has stopped but I still fill the pressure in my bladder but The area has never itched or caused pain, I only saw it cause I am always looking down there worring. I am not going as much as I was.  I guess I am alittle worried cause these can all also be symptoms of hsv also.  Would a vulvar specialist know the diff between hsv and LSC and can they be mistaken for each other.  The red area is very small, has not changed in a week, maybe it is getting a little less red. It's more like a line type shape than a circle or anything. It is not raised or anything. They took a urine sample and I am waiting the results.  If the result is neg for a uti, should I be concerned about hsv again?

[worried2007]

Thank you doctor for your response.  I guess since I have been thinking I have herpers for so long, it is hard to stop thinking that way. My doctor put me on cholestabol0.05 ointment(might have spelled that wrong) once a week and for me to come back in 8 weeks to see the progress.  I have researched LSC and I don't really sratch alot to me.  I guess I do rub the areas since I am check myself like three times a day.  Trying to stop that as well.  I thinks it's becoming a OCD. They say you can sratch in your sleep so maybe I was doing that and not knowing it.  I guess I keep worrying about herpes because they say so many people can have it and not know it or mistake it for something else.   Why are the symptoms so diff. in people?

[Alan Rockoff, MD]

I see no reason for you to be concerned about HSV at all.  LSC refers to eczema that has been chronically rubbed.  This is common in the vulvar area, and makes all the sense in your case because you've been so concerned about it that you've examined and no doubt rubbed the area.  The UTI, if you have one or not, is not relevant one way or the other.  After three tests and a biopsy, it's time for you to stop worrying about HSV and move on.  Topical anti-inflammatory creams like mild steroids should help.

Take care.

Dr. Rockoff