Causes of redness/fissures of vulvar skin

[JBee70]

Hi there,

I have had symptoms since last June (07) that I have had all infectious conditions ruled out. I am now looking at biopsy of the vulvar skin to uncover some answers, so I wanted to post here to see if any other women have gone to a dermatologist and had results. I have posted on the women's health forums here, but since i have ruled out std's, fungus, bacteris, yeast, hormone levels, strep-B, etc etc, this is clearly a skin issue.
What happens is that I get occassional redness and mild itching of the vulva. My Dr. has observed that my cervix is also reddened at these times. I get a recurring fissure that is located in a natural skin fold next to my clitoris, and one that appears sometimes on my perineum. I have also had what feels like a fissure on my anal area, it will burn and bleed a little when I wipe.  My gyn prescribed a zpak when I also (in october) began having a thick discharge with elevated white cells. ALL tests were done, no answers. Meds do not affect it.
My reproductive endocrinologist tested my hormones, cortisol, tsh, etc etc- all normal. I do have anti-thyroid antibodies as well as antiphospholipid antibody syndrome, which are both auto-immune diseases. I am asymptomatic for both.
WHAT on earth could be causing my symptoms above??? I am not looking forward to a biopsy, but I am wondering if it is Lichen Sclerosis? The redness and fissures do respond to Clobetasol treatment. In fact i went for 6 weeks without a "flare" from mid-november 07 to January 08.
Anyone have ideas?

[CeeTee]

I have had the same thing you describe for about 15 years - with some times better than others, but always there to some extent.  My dermatologist diagnosed "stress eczema" and prescribed Elidel.  I had pretty good results with it, but the problem would always come back.  (I had the fissures in the same places you describe).  About 4 months ago nothing was working and I thought about using something my sister, who has Lupus, uses for her skin - Cetaphil.  It comes in several versions, but I started using the Daily Facial Cleanser on my vaginal area with wonderful results.  It is the purest cleanser I've ever seen. Cetaphil also makes an Antibacterial Gentle Cleansing Bar, which I'm using also - but the Daily Facial Cleanser is the best.  So, I have some to the conclusion that I really have had a reaction to the bath soap I had used.  Safeguard for several years after the onset - and then Zest for the past few years.  I also had used other kinds of soap - Ivory, Dove, even Aveeno - but none of them really helped.  I occasionally use a very little Elidel now.  I haven't gone this long without a flare up in 15 years and I'm sticking with Cetaphil unless I have a problem again, and then might see a dermatologist again (I have moved states.)  Perhaps this might help you.  It's a terrible thing to have and I wish you well.  After those of us who have it go through so much to find out what the problem is, I thought it would be quite interesting if it just turned out to be a very sensitive soap reaction!

CeeTee

[AJ95]

I too am having the same symptoms, and have perplexed 3 Doctors.  I researched on the net and determined that it could be Lichen Sclerosis and took this info. to the gynecologist with me.  He said it could be that but isn't sure and even wants me to be checked for Chrone's disease.  This problem is apparently very common from what I've discovered on my vast search of the internet so why are Doctors so perplexed by it? I will take any answers and treatment advice offered.
AJ95

[AJ95]

A week after seeing my Doctor and following the advice of CeeTee, my condition is almost completely cleared.  I stopped taking baths and now shower only, not using the dove soap and just mild cleanser and water.  My gyno had prescribed a steroid cream which I have used a couple of times.  I now believe it to have been a reaction to soap and possibly aggravated by sitting in the soapy bath.  Thanks CeeTee for the tip, I and my husband are much happier now.

[JBee70]

Hi ladies,
Thank you for the posts and info..
I wanted to update that I had a biopsy of the vulvar tissue in late May. Results were negative.... except that I was found to have "chronic dermatitis". I did more research online and found a condition called "DIV" (desquamative inflammatory vaginitis). It causes redness, itching, fissures etc... And when you've been tested for all infectious and non-infectious conditions and they are all negative, this is what alot of women end up being diagnosed with.
Its cause is unknown, but it responds to a 2 week therapy with Clindamycin cream (vaginally) and hydrocortizone suppositories (again, vaginally). I did this as prescribed and all of my symptoms went away.. They've been gone since early June!
I am thinking that I had some sort of allergic reaction (hence the chronic dermatitis on the biopsy) that just went haywire!??
Anyway, I am hoping that this won't return, but if it does, at least I know what worked for me!!
Thanks again!

[gillbill]

I wrote a long reply and it is not posting for some reason. Long story again….
I have same thing in same place, one side only.  
I am fairly high stress, but even during low stress it is present.
I change my underwear frequently to keep dry. Not changing them seems to make it worse; changing still doesn't solve the problem.
I wear white wall-mart cheapy underwear. I thought it could be something in the processing of the material. Had heard they actually have white dye and thought it could be sensitivity to the dye.
I thought it might have something to do with being gassy, or eating foods that I may have a sensitivity to, either because they makes me gassy, or because it could be an allergic reaction. Could an allergic reaction from food show it self in this area?
I use the cheap individually wrapped industrial TP from SAMs.
We use Poly...Condoms for protection and mineral oil for lubrication, because I thought the spermcide/other condoms were irritating. Also stopped oral sex, obviously, but because I thought that was causing it... It came back without that as a possibility.
I use "free and clear" detergents, mostly arm and hammer, but once another kind.
When I sit on the computer and create a little oven of sorts by sitting up straight, it seems to get worse, but not always and not sitting doesn't let it go away.
Jeans seem to make it worse. I go with out pants, allowing plenty of air flow when I can at home. Which obviously doesn't solve the problem... AND isn't suggested for "in the office."
I do everything wrong and it goes away, I do every thing right and it pops up. I played in the hose with my daughter, wet pants, and then went to the pool, wet bathing suit and that night it went away. The pool, by the way, is salt water, so maybe salt sit baths could help?
Please lets keep talking, and solve this, none of us have a Cindamycin deficiency and I fear that antibiotics could be whacking something else out of balance.

[gillbill]

Meant to say, the other day I tried balmex diaper rash meds for a couple of hours and it seems to of helped. Could be another coincidence. And thanks for the soap suggestion, will try that also! For now it is hardly visible, seems to heal very quickly when conditions are favorable, but it takes no time to pop back up either. Good luck to everyone with this one...

[JBee70]

Hi there,
I read your post and just wanted to respond to the "free and clear" detergents that you said you use..
The reason I ask is because in trying to trace my problem back to when it began, it was when I had decided to switch to "free of dyes" organic "petroleum free" environmentally friendly detergent and toilet paper.
I went on this "go green" spree, and converted to these products. THATS when I started itching and having fissures. A whole YEAR later, I am finally symptom free after multiple dr. visits, tests, biopsy, and even then I STILL had to self-diagnose by reading websites!!!
Chronic Dermatitis can apparently really cause problems down there!! Since Clindamycin and Hydrocortizone suppositories are not as serious as using steroid creams, it seems worth a try for anyone whose Dr. can't figure this stuff out!
best of luck..

[JBee70]

PS- I went back to conventional detergents and toilet paper!!!!