A Post-Menopausal woman complains of itching over labia majora for 4 years with minimal relief in itching with topical medication. On examination there is an indurated lesion over right labia with positive inguinal nodes. Most appropriate management is?
Intractable itching in Post-Menopausal age group with indurated lesion with inguinal lymph nodes appears to be a case of vulval carcinoma warranting a biopsy of the lesion.
Topical beclomethasone
Topical estrogen with antibiotic
Amoxicillin + clavulanic acid and follow up for lymph node status
Biopsy
Vulvar cancer