7th August 2020

A 46-year-old lady presents with symptoms of pruritus vulvae

A 46-year-old lady presents with symptoms of pruritus vulvae. The patient has well-defined roughening and thickening of the skin and accentuation of skin markings around her vulva. The patient complains of severe itching, and compulsion to scratch and subsequently the chronic scratch-itch cycle has worsened the roughening of the skin. The patient has a history of generalised anxiety disorder. A diagnosis of lichen simplex is made. 

What would be the appropriate first step in managing this condition? 

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