11-year-old girl is brought to the office due to vulvar itching. The patient first had the pruritus intermittently, but her symptoms have
worsened over the past several months despite nightly application of a moisturizing ointment. She now has trouble sleeping due to
the constant itching. The patient has no known medical conditions and has had no surgeries She has not reached menarche and is
not sexually active. The patient is on a community swim team and has swim practice multiple times a week and uses the same
bathing suit. Vital signs are normal. Examination of the vulva reveals thin, white skin with excoriations extending to the perianal area.
The superior portions of the labia minora are adherent at the midline. A small anal fissure is also noted. Which of the following is the
most likely diagnosis in this patient?
- QA Candidiasis
- 0 B. Condyloma acuminata
- 0 C. Labial adhesions
- 0 D. Lichen sclerosus
- 0 E. Streptococcal dermatitis
- 0 F Vaginal foreign body
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