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Case discussion:Valvar Carcinoma with pre exesting Slerosus (VS)

78F, HTN ,non diabetic, Valvar Carcinoma (operated )in prediagnosed Valvular Lichen Simplex Atropicus(valvar sclerosus -VS).. C/o burning,irritation after urination..(micturation) Symptoms presented since 2013 Lical examination note of dermatologist in Sept 2013 is, scaling of vulvar skin with whitish pigmentation of near Labial skin.. She was diagnosed as Lichen simplex Atropicus of vulvar area in 2018...and treated with local emoluents and steroidal applications but with minimal and unsatisfactory relief in symptoms.. In Aug.2020 she was diagnosed as Valvar Carcinoma and operated.. Symptoms persisted..with shooting pain at operated site with Burning after micturation... Labia fused with no visual external urinary miatus.. Treatment started on 23rd Oct 2020.. Status as of today. Burning & pain reduced significantly. Visualising external Urinary miatus.. Redness near urinary aperture decreasing..l Previosly adhered(fused) Clitoris to labia getting elevated and relasing to original position.. LA of Jyesthmadh tail + Shatdhaut ghrit.. Occasional lignocain gel 2% LA...now required only twice a day, rarely thrice. Through out no oral pain killers given or required.