Pruritis vulvae

Question 1

Define pruiritis vulvae.

Answer 1

Pruritus vulvae is itching of the vulva (which includes the mons pubis, labia majora, labia minora, clitoris, perineum and the external openings of the urethra and vagina). It is a symptom which is common to many conditions.

Question 2

What is the aetiology of the pruritis vulvae? What are the risk factors of pruritis vulvae?

Answer 2

Contact of the vulval skin with shampoo, bubble bath, vaginal washes, or wet wipes.

Tight-fitting garments or synthetic clothes.

Fabric conditioner or biological washing powder.

Spermicidally-lubricated condoms.

Coloured toilet paper.

Question 3

Summarise the epidemiology of pruritis vulvae.

Answer 3

Common

Question 4

What are the signs and symptoms of pruritis vulvae?

Answer 4

Itching around the vulva

?Rash

Question 5

What investigations should be performed for pruritis vulvae?

Answer 5

Clinical diagnosis

Diagnose and treat underlying cause as pruritis vulvae is a symptom

Question 6

What are underlying causes of pruiritis vulvae?

Answer 6

Dermatological conditions

Infections and infestations

Neoplastic conditions

Hormonal changes (atrophic vaginitis)

Gastrointestinal disease and urinary incontinence

Systemic causes

Question 7

What are complications associated with pruritis vulvae?

Answer 7

There is a small risk of developing squamous cell carcinoma for women with lichen sclerosus (less than 5%), and lichen planus (less than 3%)

Complications may also result from chronic itch:

Psychological problems, such as depression, and anxiety

Sleep disturbance

Severe and irreversible architectural damage due to chronic, deep scratching and gouging

Lichen simplex

Secondary bacterial infection (usually with Staphylococcus aureus) is common in excoriated skin