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Vulvar dermatoses may be manifested by itching and, in some cases, pain ( Figures 3 through 5 ) . Vulvar dermatoses include papulosquamous (thick and scaly) lesions. Erosions or ulcers may result from excessive scratching. If the patient has blisters or ulcers and denies scratching, the cause may be a vesiculobullous disease. Differential diagnoses of papulosquamous lesions and vesiculobullous lesions are included in Table 2 . 6 Neoplastic lesions include extramammary Paget's disease, squamous cell carcinoma, lichen sclerosis and vulvar intraepithelial neoplasia. 6 Colposcopy and biopsy as indicated are recommended to rule out dermatoses or neoplastic lesions ( Figure 6 ) . A recent study showed the most common cause of symptomatic vulvar disease (itching or burning) to be dermatitis or another dermatosis. 18
I found an old interview with you regarding your book on
Pregnenolone. Checking out your website, I notice you have warnings about
dosage. Have you changed your mind? Do you think it has too many risks? For me,
Pregnenolone feels like a miracle. I have suffered with vestibulitis for ten
years .. all the years that my hormones have been plummeting. I am 47. I have
always been fit. I believe my hormone issues are from having been on the pill
for years to control endometriosis (I quit the pill ten years ago also, but I
had started having symptoms before that). Anyway, I have tried every Rx, diet,
PT, herb, acupuncture, etc. Bio-identical hormones gave some help. Recently I
tried pregnenolone and my pain immediately decreased by 75% and I had a sudden
urge to paint, which I have not done in 15 years! Do you feel it is risky for
someone like me, who produces very little of any key hormones, to take
pregnenolone 10mg/day? Or was that warning more for folks who still produce
normal levels? I hope you'll write back. I am AMAZED to find an MD who knows
what this is and what it does.
A. I think one should be cautious taking 10 mg a day for prolonged periods. I good idea is to adjust the dosage periodically to find the lowest amount that works and to also take a couple of days off each week if possible.