Pruritis vulvae Flashcards
What is pruritis vulvae?
Just means itchy vagina
Commonly caused by vulvovaginitis - (candidiasis, atrophic vaginits, vulvar vestibulitis, contact dermatitis - so infection , eczema, contact dermatitis
and most women get candidiasis in their life
40% of post menopausal women get atrophic vaginitis
Sx of pruritus vulvae
DEPENDS on causes
vulvovaginal candidiasis-
Vulvar pruritis, burning, red, which curd like discharge
atrophic vaginitis- sore, dyspareunia, leucorrhoa (white discharge), spotting
Vulvr vestibulitis-
primary- introital dyspareunia (pain during sex)
Secondary - dyspareunia that develops after period of confortable sex
+pain, soresness, burning, “rawness”
Contact dermatitis-
itchy, burning, red, ulcerated skin
Ix of pruritis vulvae
for candidiasis - wet mount Slide, KOH prep
Atrophic vaginits- pH and Wet mount test (RBC and no signs of BV)
Mx of pruritus vulvae
Candidiasis - ketonazole/fluconazole 6 weeks
clotrimazole
atrophic vaginitis- vaginal oestrogem or HRT
vulvar vestibulitis- pain mx with sex therapy. CBT
topical steroids, anesthetics, lube,
surgery as LAST resort
contact dermatitis- remove itching agent,
mild -1% hydrocortisone creame
Moderate-betamesone
Severe- wet compress with aluminum acetate
Complications of pruritus vuulvae
Atrophic vaginitis - infection due to raised pH
candida-disrup social life
prog-
atrophic -good relief when treat
Candida- good but reccur in 5%
