A Woman with Pruritus Vulvae (2)
Margaret (Case 11 and 24) returns to the Sexual Health clinic 6 years later with a 4 week history of vulval itch. Although she has had no recurrences of candidiasis for 3 years, she thought that candidiasis was the most likely cause of her symptoms and she self-medicated with oral fluconazole and topical clotrimazole, obtained over the counter from a pharmacy. Her symptoms, however, remain unchanged and she consults you for advice. When you examine her, the findings are similar to those described previously, but you decide to send a specimen of vaginal discharge to the laboratory to confirm the diagnosis.