Successful management of vulvar adhesions with potent topical corticosteroids: a case report.
BACKGROUND
Vulvar adhesions are a rarely reported but clinically recognized complication of severe ulcerations following herpes genitalis. The condition is avoidable with adequate pharmacologic treatment, hygiene, separation of the labia and topical application of skin emollients.


METHODS
Vulvar agglutination was diagnosed in a 23-year-old woman following hospitalization for severe herpetic vulvar ulcerations. Manual attempts to separate the labia under local anesthesia were unsuccessful. Topical application of a potent cortico- steroid led to separation with no residual effects.


CONCLUSIONS
Preventive and proactive management of extensive herpetic vulvar ulcerations should be the first line of care. There will always be patients who will present at a later stage of the disease, with established vulvar agglutination; there potent topical corticosteriods could prove valuable. There is no literature on the use of topical corticosteroids as the primary treatment for vulvar adhesions, and further studies are essential.
Markos
Atef R
AR
Department of Genitourinary Medicine and Sexual Health, Staffordshire General Hospitals, National Health Service Trust, Stafford, UK.
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006558:Herpes Genitalis / Q000150:complications*; D006801:Humans; D000267:Tissue Adhesions / Q000188:drug therapy; D016896:Treatment Outcome; D014456:Ulcer / Q000150:complications / Q000209:etiology; D014845:Vulvar Diseases / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones