Direct fluorescent antibody testing should also be performed to differentiate between varicella and herpes simplex vims type I or type 2. When herpes is present, oral acyclovir may provide partial relief of symptoms. When used for recurrences, it must be given within 2 days of the outbreak of lesions to be effective. Topical acyclovir should not be prescribed because it is less effective. The etiology of this disorder is unknown, but may be related to an autoimmune disorder.
Children often present with bleeding because the skin is easily traumatized.
Alternatively, vaginal discharge may be the presenting complaint because secondary infection is common. Chronic cases may result in atrophy of the labia majora or clitoris, constriction of vaginal introitus or urethral meatus, anal stenosis, or anal fissures. Hydroxyzine hydrochloride also may be administered to relieve itching. It characteristically affects the face, neck, chest, and extremities. Chronic cases may result in crusty, weepy lesions of the vulva that are accompanied by intense pruritus and erythema.