- 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.
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.
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)
- Vaginal hygiene products
- Topical medications
- Body fluids
- High-risk sexual behavior
- Avoid irritants.
- Tight-fitting clothing should be avoided.
- Only cotton underwear should be worn.
Commonly Associated Conditions
- Infectious etiology
- Vaginal or vulvar candida
- Gardnerella vaginalis
- Human papillomavirus
- Herpes simplex virus
- Vulvar vestibulitis
- Lichen sclerosus
- Lichen planus
- Lichen simplex chronicus (squamous cell hyperplasia)
- Malignant or premalignant conditions
- Fecal or urinary incontinence
- 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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Domino, Frank J., et al., editors. "Pruritus Vulvae." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688599/all/Pruritus_Vulvae.
Pruritus Vulvae. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688599/all/Pruritus_Vulvae. Accessed June 4, 2023.
Pruritus Vulvae. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688599/all/Pruritus_Vulvae
Pruritus Vulvae [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 04]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688599/all/Pruritus_Vulvae.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pruritus Vulvae ID - 1688599 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688599/all/Pruritus_Vulvae PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -