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Pruritus Vulvae

Maeve K. Hopkins, MA, MD and Michael P. Hopkins, MD, MEd Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Pruritus vulvae is a symptom, or can be a primary diagnosis.

  • If a primary diagnosis, other etiologies must be excluded.

  • Pruritus vulvae as a primary diagnosis may also be more appropri...

DIAGNOSIS

Pruritus vulvae is a diagnosis of exclusion. 

HISTORY

  • Persistent itching

  • Persistent burning sensation over the vulva or perineum

  • Change in vaginal discharge

  • Postcoital bleeding

  • Dyspareunia

PHYSICAL EXAM

TREATMENT

Identify the underlying cause or disease to target treatment. 
  • Stop all potential irritants.

  • Eliminate bacterial and fungal infection.

  • Cool the affected area: Use cool gel packs (not ice packs,...

ONGOING CARE

  • Frequent evaluation, repeat cultures, and biopsies are necessary for cases resistant to treatment.

  • Refractory cases may require referral to gynecologist or gynecologic oncology for further...

REFERENCES

1
Farage M, Maibach HI. The vulvar epithelium differs from the skin: implications for cutaneous testing to address topical vulvar exposures. Contact Dermatitis.  2004;51(4):201–209. [V...

ADDITIONAL READING

  • Banerjee AK, de Chazal R. Chronic vulvovaginal pruritus treated successfully with GnRH analogue. Postgrad Med J.  2006;82(970):e22. [View Abstract on OvidMedline]

  • Boardman LA, ...

CODES

ICD10

  • L29.2 Pruritus vulvae

  • N94.819 Vulvodynia, unspecified

ICD9

  • 698.1 Pruritus of genital organs

  • 625.70 Vulvodynia, unspecified

SNOMED

  • 67882000 Pruritus of vulva (disorder)

  • 238968009 vulvodynia (disord...

CLINICAL PEARLS

  • Pruritus vulvae is a common complaint.

  • Pruritus vulvae is a diagnosis of exclusion once other causes of itching have been ruled out.

  • Exam-directed biopsies from any ulceration, discolora...

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