Hey everyone, welcome back to MasterUSMLE! Today, let’s talk about a high-yield Step 2 CK topic—vulvar cancer and when to biopsy suspicious lesions.
Picture this: A postmenopausal woman comes in with chronic vulvar itching and a firm, white plaque on the labia majora. She has a history of lichen sclerosus, which should immediately set off alarm bells—because long-standing lichen sclerosus is a major risk factor for vulvar cancer.
So, what’s the move? Vulvar biopsy. Always. Don’t just throw steroids on it and hope for the best. If it’s precancerous (VIN), you can treat with imiquimod or laser ablation. But if it’s invasive? Surgical excision, possibly with lymph node dissection.
The key takeaway? White, firm, or ulcerated vulvar lesions in postmenopausal women = biopsy, no excuses.
That’s it for today—keep it simple, stay sharp, and I’ll catch you next time on MasterUSMLE!
