A 67 yeаr оld wоmаn presents with vulvаr pruritus fоr the prior year that has been increasing over the past few months. She established menopause at age 49 years. She has been compliant with HRT since that time. On physical exam, there are velvety, erythematous lesions bilaterally on the vulva, there are also some white plaques. The first step in the management of this patient would be: