Candidiasis vulvar y liquen escleroso: diagnóstico diferencial

Candidiasis is an infection caused by different types of Candida fungus, the most frequent being Candida albicans, characterized by the presence of white, curd-like discharge. In the differential diagnosis, when lichen sclerosus is suspected, the symptomatology is confirmed by anatomopathological studies. The importance of making the right diagnosis in a timely manner avoids mistakes and directs to the application of an adequate treatment. In this case study, the differential diagnosis of vulvar candidiasis and lichen sclerosus was determined in a 48-year-old menopausal patient who claimed to present: hot flashes, vaginal dryness, lack of vaginal discharge. For a year and a half, she has presented: intense itching and redness of the vulvar and perineal area, scaling skin; she received treatment for Candida Albicans, with improvement and recurrence. On gynecological examination, an atrophic, brownish dry vagina was observed, without whitish vaginal discharge, erythematous vulva and perineum, hypersensitive shiny scaly skin. A sample was taken for biopsy, confirming the result of lichen sclerosus. With prior informed consent, treatment was started with platelet-rich plasma sessions every 21 days for 3 sessions; in addition, 3 drops of ozonated oil daily between the major labia were indicated, among others. After treatment, a partial improvement in symptoms was evidenced, vulvar itching and reddening (50%) and skin desquamation (80%). It was recommended to perform 2 more cycles of treatment in the following 6 months.