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Pruritus Vulvae

Sareena Singh, MD, FACOG Reviewed 05/2023
 


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 appropriat...

DIAGNOSIS

Pruritus vulvae is a diagnosis of exclusion. Delay in diagnosis is common due to patient hesitancy to seek treatment or provider delay in biopsy. Delayed diagnosis can have profound negative...

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
Stockdale  CK, Boardman  L. Diagnosis and treatment of vulvar dermatoses. Obstet Gynecol.  2018;131(2):371–386. [View Abstract on OvidMedline] ...

ADDITIONAL READING

  • Böttcher  B, Wildt  L. Treatment of refractory vulvovaginal pruritus with naltrexone, a specific opiate antagonist. Eur J Obstet Gynecol Reprod Biol.  ...

CODES

ICD10

  • L29.2 Pruritus vulvae

  • N94.819 Vulvodynia, unspecified

SNOMED

  • 67882000 Pruritus of vulva (disorder)

  • 238968009 vulvodynia (disorder)

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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