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?

[daffodil20]

I am so glad I have found this.

I have been experiencing these symptoms for about 2 months. First treated like a yeast infection. Then the fissures started happening more often until I couldn't have sex without getting them. Am waiting to see a proper doctor in a few days, but the walk in clinic doc just took swabs for STI (negative) and left before I could ask her my barrage of questions.

In the meantime I will be trying some of the suggestions here to relieve the general tenderness, rawness.

I am truly convinced it is some sort of lichen, from the photos and symptoms I have seen, and I wonder if this has to do with changing brand of birth control pills twice in the last year? Thank you ladies for your advice.

Daffodil

[johnson85kj]

I too am much relieved that I am not the only one who has these symptoms.  Mine started about 3 years ago with just a couple of fissures.  I had just begun getting waxed "down there" and thought it was irritation from the wax or the ripping of the wax off.  The fissures persisted with itching and irritation.  I finally went to the gyn who diagnosed me with herpes even though the culture she performed was negative.  I have since been taking a daily Valtrex to help reduce viral shedding, even though I am not convinced I actually have herpes.  I have never had any ulcerations in my genital area.  Anyway, my symptoms have gotten worse over the past 8 months.  I've considered the possibility of allergic reactions to various product like soaps, detergents, spermicides, lubricants, latex, etc.  Nothing seems to be the culprit.  I have noticed that the symptoms become more severe about 10 days before I begin my period.  This makes me believe that it may indeed be hormone related.  I too have been treated for yeast and BV to no avail.  I have self-medicated with Vagisil, hydrocortisone cream, and eucerin cream.  The hydrocortisone seems to have the most benefit for me.  My research on the internet has also led me to believe that it may be lichen sclerosus.  I am happy to find that others believe the same thing about themselves.  I tried to make an appt the other day and was told there were no appts available for the rest of the month and to call back on Friday when June's calendar would be open.  Nice! Anyway, thanks to all of you who have shared your stories and what has helped for you.  

[Ruby310]

I was originally diagnosed with herpes months ago and after having gotten a second blood test and finding out that it had been a false positive, I have been searching for an answer to my chronic problems which include severe burning and intense itching, swelling, cracks, and tenderness.  Reading about your situation makes me feel so much more understood.  My gynecologist just keeps patting me on the back and saying, "It's probably just yeast, here's a Diflucan prescription and always wear Granny underwear!" - I went on a yeast-free diet, took Diflucan and have felt no relief.

A dermatologist took a look and said he just sees irritation.  He gave me some Aquaphor and Balneol (both over-the-counter) and still no relief.  In fact the Aquaphor caused a yeast infection--it's the consistency of Vaseline, which is not the best thing to apply in the vaginal area.

I'm so frustrated and anxious and miserable.  I don't imagine that even if I start dating again I'll be able to have sex at all.  Nobody has been able to diagnose me with anything - all my STD tests came back negative and I also don't have a bacterial or yeast infection, according to my swab tests.  

After having done my own research, the closest thing I can come up with is Lichen Simplex, which is basically just eczema, and I'm following the recommendations for this but still unbearably itchy.

[nananananana]

I have had a problem similar to above for over a year now.  Itch, pain, redness, lesions and mainly on one side.  Bizarrely I have also had the same sensation up my nose, in my ears and down the back of my throat. I have seen many many doctors, two dermatologists, sexual health professionals, an immunologist, an ear nose and throat specialist etc etc... I have had every diagnosis under the sun from allergy (patch tested- there is nothing), to possibel STIs (negative), to sebaceous cysts (so why the continuous itching etc when the lesions are not there), to acid vagina (this must be the weirdest), to stress, to vulvodynia (this is where doctors go when thye don't know what to say next- ie: random pain syndrome).  Vulvodynia was the most depressing as the answer always was its a confused nerve signal, we don't know what to do about it.  To which I would say so why the rash- no answer.  I have even been sent out of the doctors rooms to counselling to help me deal with the annoyance of having to live with the condition.  This was just frustrating, I don't want counselling I want to sort this out.  I have been tested for every STI there is about five times each- negative.  I'm been tested for semen allergy.  I've had biopsies and been checked for cancer.  I've used every kind of steriod available, tried salt baths, the acid vagina ladies even had me testing my ph levels and squirting baking soda up there every night- until that didn't work and I was sent to the counsellor- um thanks.  I've been wearing cotton bloomers and using unscented soap and loo paper and detergent for a year now.  At my worst I had to take days off work and sit with my legs apart with no undies on for a day.  There is actually no one left in the field of conventional medicine left to talk to.  I have booked myself in for my first session with a naturopath beginning of March- so we shall see!

Reading these posts is like holding up a mirror and makes me feel strangely a bit better.  The medical profession really are not on top of this issue.

[jmh2630]

Wow!  I've been dealing with this exact issue for a couple of years.  My GP said low estrogen too, but turns out she was wrong.  I finally talked to my gyno about it and he said maybe lichen sclerosis or herpes, but none of the herpes symptoms fit.  I've look at numerous pictures of both herpes and sclerosis, and it definitely does not look like herpes.  The problem with the sclerosis pictures is they are mainly of post menopausal women who have suffered for a long time.  Know of anyone pre-menopausal suffering?  I guess I really need to get that biopsy done.  

[amw7608]

I have this as well. I went to the gyno, and she said it was caused by low estrogen levels and prescribed an estrogen cream to be applied directly to the fissure. (It's a cream for menopausal women who have vaginal dryness.) Five days later, I'm not convinced she was right. Symptoms haven't much improved.