Discussions that mention temovate

Women's Health board


Hello, ladies.

First off, this is rather long, but please bear with me!

I'm trying to get some more feedback from women who have experienced this so as to try to get to some sort of resolution about my problem.

Almost 3 years ago, I started noticing soreness and a slight itching in the upper folds of skin (labia area). Upon inspection one day around that time, I felt a small pimple-like "bump." I brought it to the attention of a former OB/GYN that I had, the same guy who performed my third c section.

Now, this 'bump' (which I recently found out is a very deep-rooted sebaceous cyst), moves around like these cysts tend to do, so it can be difficult to 'recreate' it for a physician to see.

The doc at that time obviously didn't have much of a clue what I was trying to tell him and wrote the words "vulvar lymph node" on the medical paper. I don't remember him telling me these words to my face.

I looked up the topic online, and all I saw on the subject was the word cancer, which obviously scared me, so I sought a 2nd opinion, this time from a totally different OB whom I had never seen before.

She was thorough with the exam but came up with zippo; that is, she didn't see any problems, growths, bumps, etc. in the area. I felt reassured by this and went on my way, cyst in tow (unbeknownst to me, of course...
:rolleyes: )

Fast forward to now: In December of 2005, I had a cat scan to confirm a ventral/incisiona hernia that I incurred after my last c section. My surgery was in January 2006. The ct scan also revealed a dermoid cyst on my left ovary. That was surgically removed in March.

At my first post op visit with my new OB GYN, I brought up the subject of this 'mysterious' irritation in the gyno area, but he didn't take the time to look at it but mentioned something about prescribing [Diflucan, I think], although I didn't see how he could prescribe ANYTHING w/out first looking at the area in question (just a typical response that a lot of these doctors have...)

I got a new doc because I didn't want to deal with the 'old' group, and I needed a doc who had privileges at the same city hospital where my hernia surgery took place at in the event both docs needed to work side by side in the operating room because I have hernia mesh inside of me...)

BTW, the general surgeon didn't need to assist...

Moving on...

This cyst was still active when I had my second post op visit with the new OB GYN. He did look at the area but actually seemed more concerned about taking a culture, which did not turn up yeast or bacteria.

However, he showed no signs of detecting any cysts. Amazing, isn't it? (insert sarcasm)

Well, he [automatically] prescribed Temovate, a very high-powered steroid cream and wrote down 'dermatitis.' Lots of previous online research had me wondering if this is what the problem was.

Well, let's try something, I thought. So I did.

During the first week/week and a half of the treatment, the skin felt a little better, and I had no ill effects from it. The 'warning' on the paperwork associated with this cream said that it could thin the skin, it could get into one's bloodstream (that might be if you used it beyond the time you were told to), which was 2 weeks tops and no longer, you are to report use of this cream (present or past use) to all of your doctors, and you should watch out for any of the side effects listed for up to 1 year after discontinuing it. Sounds kind of major, eh?

Well, towards the end of the treatment, I had made up my mind to ask the doctor about the subject of vulvodynia/see if he was knowledgeable about it and if he was willing to put up with some trials to see if they would help because the area was still sore, etc.

It never got to that point.

Guess why?

Well, 2 Sundays ago, the Sunday before Mother's Day, around 12 noon, I would notice that the area (the left side) started to HURT, which escalated into pain for over 2 hours. I finally took a peek with a mirror and a flashlight, and the area was red and extremely inflamed. A second look (and feel) revealed a large lump somewhere deep inside my skin.

This really got me going, and I was almost ready to go to the [city] hospital where I've had my 2 surgeries at.

It was Sunday; go figure.

I did soak in the tub, at the advice of a friend of mine who's a nursing supervisor at a local hospital, and the pain went down considerably, but the lump remained well into the next morning, good for the doctor to finally see.

I was fortunate enough to get a same-day appt. with him. I actually had to point to the area that was injured. He said right away that I had a cyst (imagine that! I've had a pilonidal cyst (tailbone) and the dermoid cyst on my ovary, and now a sebaceous cyst in the gyno region. Great, just great! :o )

He took a sample of fluid or something when he left the room. I thought for sure he was going to get his tools (he made it known that he wasn't going to do anything surgically rather quickly, though) and lance or extract the thing.

His philosophy (here it comes) was for me to either take sitz baths or have tub soaks to "try to get it to come to a head." Why in the world would it do that in one week if it hadn't done anything in nearly three years?? My mom didn't understand that theory, either.

I conceded and asked him what to expect from him in a week if this was still bothering me. He said that he'd lance it (he wasn't looking at me when he said it, like he was arguing with himself in an effort to provide me with an answer).

One thing (there is more than one) that bugs me is that he revealed to me that he usually "sees 2-3 of these a day" when women have their yearly exams and asks THEM if they know that they have one/does it bother THEM? Why didn't he see mine in January when I had my exam or the other day then?

The jury's still out on that one...:rolleyes:

Well, I went ahead and made my appt. ahead of time, that Thursday, for the visit that took place this past Thursday, May 18, with the full intent that the cyst was "going down..." ha ha

No such luck!

Got in there, told his medical assistant that it was still bothering me, he came into the room when I only had gotten my shoes off (any other time he seems to take his time...), and he looked at it, almost didn't 'find' it, and, from the way he was acting/talking, it was evident that nothing surgically was going to take place! Can you believe it??

He said that

1) It's small and deep rooted (knew that).

2) It's not infected or inflamed.

3) It's 4 mm in size

4) It's sebaceous in nature (so what?!) and, because it freely moves around and is not of a malignant nature, that there's no need to "do overkill" on it.

5) Said that it's here to stay. :confused:

I think he's a good doctor; he's a patient doctor (he'd have to be to deal with a 2-hour dermoid cyst removal and saved my ovary in the process! LOL), and I think, once he knows the game plan, he's the guy to have on one's 'team,' but I had already figured out for myself that he's on the side of the "conservative camp." :rolleyes:

I asked him what am I supposed to do if it flares up again? He said, "I'm a surgeon (duh!), and people think of surgeons as knife happy (not his words but mine), and I'll be more than happy to get out my tools then..." blah blah

From what I've been reading online, a doctor doesn't want to lance/excise something if the area is infected. Is this the norm?

Is this solely an Ob/gyn's territory, or could a dermatologist handle it due to it involving the skin? This is what I'm confused about.

I made an appt. with a diferent ob/gyn in the city for 2 weeks (I can't get in any sooner) for a 2nd opinion on the matter. If he doesn't want to do anything with it, I don't know what I'll do. My spouse's job will be ending in the middle of July, and we won't have health insurance coverage after that date. I made this known to my present ob/gyn because I was trying to relay to him that I'm trying to take care of this thing NOW.

I can't understand why he would retreat, not doing anything, when he knew full well that we were 'in agreement' about the plan. I don't know how much experience he has with these, as I think this is his first ob/gyn job (he's in a group practice).

Thoughts welcome,

Hoosier


Have any of you ladies experienced a similar situation?

P.S. I wanted it excised, as I know that all a lancing is involves an incision and drainage, and that doesn't remove the sac/cavity that the cyst is in, and the cyst would recur/still be there, etc.
I don't know if this thing will ever come to a head, but I don't do the tub soaks daily.

It still bothers me, but at least it's not throbbing or anything like that. These dermatologists in Cincinnati are really difficult to get in to see due their overpopularity, lots of patients, and [overbooking].

I'd get in to see that female one, but my husband's job will be ended by that time, so that won't work. There aren't too many female derm's in Cinti, either, and I'd probably feel more comfortable trying another one.

If it only gets lanced, though, that won't remove the sac/cavity that it's in, and I might have a Word catheter in there to help with drainage (this theory may only hold true for Bartholin's gland cysts; I don't know).

The OB tried to call the steroid cream an antifungal cream. LOL Maybe he wasn't thinking clearly when he said that...

I think the Temovate aggravated the cyst; the area stayed moist with the cream on it all morning, and that's the only think that I can think that could've caused it; other than that theory, the cyst decided to flare up.

I feel confident that I'm going to find a doctor who will work with me on this, but I'd sure like to get it taken care of soon so that I can get on with life! LOL

I had a colonoscopy performed earlier this morning; thankfully, no polyps or anything serious was found, and I don't 'need' to have another one performed for "7 years." The c/r surgeon seems willing to help me take care of an "anal skin tag" that's right on top of the perineum; no other doctor consulted thus far (while I'm being examined for something else) is willing to touch it with a ten foot pole. Again, the conservative camp. heh heh

I'm to call this guy's office tomorrow (the guy who performed my colonoscopy) to discuss the skin tag removal. I think he'll remove it. If so, I'm going to get in there as soon as I can. I think it's due to anal fissures. I get them a lot, but by the time I can get in to see the c/r doc, they're gone, and it's very frustrating. I also have rectal muscle spasms, which are either from proctalgia fugax or levitor ani syndrome, but, again, there are no real "cures" for this. I have Calmol 4 hemorrhoidal suppositories, which are helpful.

The c/r surgeon didn't say anything about my internal hemorrhoid after today's procedure (unless he DID, and I was still dopey and don't remember the conversation :rolleyes: )

If this other ob/gyn concedes and does something surgically, do you think it would be a good idea to drop a note in the mail to my present ob to inform him rather than get tongue-tied in January and mention it then?

TIA,

Hoosier
Thx for the additional replies.

Well, go figure. The guy couldn't find the lil bugger! Can you believe it? Probably went into stealth mode... :o

Anyhow, he reiterated what my present doc said: it's asking for trouble to go after something if it's TINY because what will most likely happen is that the scalpel (sheer act of declaring war on something so minute) will wreak havoc on the surrounding tissue.

Use this analogy: Try going after a flea in a haystack. Chop away at the haystack just to get to the flea, only to discover that the flea (small and wiry fella that he is! LOL) has disappeared, and you've already tore apart the haystack, throwing hay everywhere and making one big mess (that may seem like a silly analogy, but it's the only way I know at this second in time to explain it in layman's terms! ha ha)

He said, "We like to get at these things when they're big," and mine evidently isn't at that stage. I don't know how large it was, though, when it flared up a few weeks ago, but if it was, that would've been a golden opportunity for my present OB to try to reduce its size.

This guy that I dealt with today mentioned Keflex and some other topical cortizone ointments, but he said that he just didn't feel/see it, but he DID say, "I know that you women get these," so he was also reassuring me that he knows that I'm not blowing hot air around...

So, my present OB isn't "fired." LOL I wasn't planning on giving him the boot. He hasn't done me wrong; he's just conservative.

The guy today was more thorough than my present OB. I don't know why my present doctor wasn't that thorough. He probably hoped that he wouldn't find anything, yadda yadda.

The area still hurts, and I was advised to continue hot tub soaks and to put some Neosporin on it (that won't hurt me), but he said that the Temovate, being a steroid, would have done nothing for a sebaceous cyst. Then again, when the Temovate was prescribed, the doctor hadn't said anything about the possiblity of it being a cyst.

Thanks for all of the replies. I need to cancel my appt. in the city that I had scheduled for next week. He would probably say the same thing. And, he might not see the little critter, either... :eek: