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However, persistent phantosmia can indicate other medical conditions such as sinus infections, neurological disorders, or in rare cases, serious conditions like stroke or brain tumors

If the affected areas extend around the vulval and perianal skin a figure-of-eight pattern can be seen The affected skin is ivory-white, and may contain areas of telangiectases and purpura As a result of friction the skin often breaks down to form a red raw surface Other features occasionally seen include hyperkeratosis, vesicles, bullae, and ulcers Atrophy is a common feature and sometimes there may be marked shrinkage of the vulva, especially the clitoris and labia minora, and the vaginal introitus

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