A 65 year old lady presents to the GP with a 2 month history of intense itching in both the vulval and perianal area. Past medical history includes Psoriasis and Irritable bowel syndrome. There is no postmenopausal bleeding or vaginal discharge. On examination the skin around the vulva and perineum is ivory white and crinkled with visible telangiectasia.
What is the most likely diagnosis?
