Well...to my amazement, 2 more Lichen sclerosus (LS) VIN III (Vulvar Intraepithelial Neoplasia on a precancerous scale of I to III) lesions: one on a site close to the urethra - so it was monitored before, and laser ablated with extra caution in Feb. - and one at "11 o-clock", as the positioning is described. I came back yesterday afternoon upset, but determined to get these ultimately removed.

The option the gyne-oncol decided we should try for 2 months is application of Imiquimod cream every evening before bed; hopefully the idea is to fall asleep before the burning becomes noticeable. Imiquimod was an "option" discussed before opting to go with the laser ablation surgery in Feb. because Imiquimod does burn I'm told, and it would have had to be applied over at least a 6 month period. I / we went with laser ablation instead in Feb., followed in April with the next outpatient surgery: excision of an area of concern that was deeper than the ablation reached; that area looks fine as of yesterday (some good news to appreciate!).

So, just to follow up for others to know where the journey can go, I will use the Imiquimod starting tonight for 2 months. If it doesn't seem to have an impact along the way (or is too uncomfortable?) I'm asked to contact her office to see her sooner. Then we would go forward with another hospital (outpatient) excision procedure under anesthesia, and recovery that, if April's experience is representative, would be at times uncomfortable, sometimes painful, but not the excruciating pain of bathroom visits for 7 weeks after the Feb. vulvar laser ablation.

If this helps someone/others, feel free to let me know with a Reply or "Helpful" star here. I may have gone into more detail than I originally intended to, but again, here on MCC of all places it seems it can be valuable to others wondering about LS (I do not do/use social media for privacy and comfort reasons).

Take care, keep on top of these things with your gyne &/or gyne/oncol, and get after it!

[BTW: having just had an annual visit with my dermatologist, I asked him what he knows of LS, and - because of posts I've seen here where folks are wondering who they go to - the derm or their gyne - he said he can ID it so that it can be followed up by your gyne/oncol with close monitoring & the needed treatment approaches. But also, your gyne would/should likely ID it at your regular visits. He also said, like other diseases/conditions (autoimmune or otherwise) 'we're treating the patient, not (curing) the disease'.]

Makes sense to me, but, as he acknowledges, lots of Qs remain, no cure, and so it is with many, many medical mysteries.

Best wishes, warm thoughts to all.

@brandysparks

Thank you for all your valuable information, I have a recheck in Sept and will read up on disease before appt to make sure I know what questions to ask. Mine is still at a treat with Clobetasol cream stage but it is spreading.

The last time I was in, the gyn provider took pictures so can do comparisons. Awkward but necessary. No different then if had skin condition somewhere else on body that needed to be monitored.

My advice to all women, no matter what age, continue to have pelvic exams. Mine was not diagnosed early because my PCP had stopped doing pelvic exams. I started having symptoms and then PCP still missed. I did my own self-refer to gyn and then it was diagnosed.

Thanks again for research.