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Pruritus Vulvae

Pruritus Vulvae is a topic covered in the 5-Minute Clinical Consult.

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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 appropriately documented as vulvodynia (see “Vulvodynia” topic) or burning vulva syndrome.

Epidemiology

Symptoms may occur at any age during a woman’s lifetime.

  • Young girls most commonly have infectious or hygiene etiology.
  • The primary diagnosis is more common in postmenopausal women.

Incidence
The exact incidence is unknown, although most women complain of vulvar pruritus at some point in their lifetime.

Etiology and Pathophysiology

Vulvar tissue is more permeable than exposed skin due to differences in structure, occlusion, hydration, and susceptibility to friction. It is particularly vulnerable to irritants such as (1)

  • Perfumes
  • Soaps
  • Laundry detergent
  • Douches
  • Toilet paper
  • Sanitary napkins

Risk Factors

  • High-risk sexual behavior
  • Immunosuppression
  • Obesity

General Prevention

  • Attention should be paid to personal hygiene and avoidance of possible environmental factors.
  • Tight-fitting clothing should be avoided.
  • Only cotton underwear should be worn.

Commonly Associated Conditions

  • Infectious etiology
    • Vaginal or vulvar candida
    • Gardnerella vaginalis
    • Trichomonas
    • Human papillomavirus
    • Herpes simplex virus
  • Vulvar vestibulitis
  • Lichen sclerosis
  • Lichen planus
  • Lichen simplex chronicus (squamous cell hyperplasia)
  • Malignant or premalignant conditions
  • Psoriasis
  • Fecal or urinary incontinence
  • Dermatophytosis
  • Parasites: scabies, Pthirus pubis
  • Extramammary Paget
  • Dietary: methylxanthines (e.g., coffee, cola), tomatoes, peanuts
  • Autoimmune progesterone dermatitis: perimenstrual eruptions
  • Irritant or allergic contact dermatitis
  • Atopic dermatitis

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Citation

Stephens, Mark B., et al., editors. "Pruritus Vulvae." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117386/all/Pruritus_Vulvae.
Pruritus Vulvae. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117386/all/Pruritus_Vulvae. Accessed April 26, 2019.
Pruritus Vulvae. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117386/all/Pruritus_Vulvae
Pruritus Vulvae [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 26]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117386/all/Pruritus_Vulvae.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pruritus Vulvae ID - 117386 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117386/all/Pruritus_Vulvae PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -