Differential Diagnosis for Labia Cyst in a 41-year-old Morbidly Obese Female
- Single most likely diagnosis:
- Bartholin's cyst or abscess: This is the most likely diagnosis given the acute onset of a hard and painful labial cyst. Bartholin's glands are located on each side of the vaginal opening and can become blocked, leading to cyst formation. If the cyst becomes infected, it can develop into an abscess, which is consistent with the patient's symptoms.
- Other Likely diagnoses:
- Epidermal inclusion cyst: These are benign cysts that can form on the labia and are often hard and painful. They can become inflamed or infected, leading to increased symptoms.
- Folliculitis or furuncle: These are inflammatory conditions of the hair follicles that can present as a painful, hard nodule on the labia.
- Hydrocele of the labia: This is a benign condition where a fluid-filled cyst forms on the labia, which can be painful if it becomes large or inflamed.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Necrotizing fasciitis: Although rare, this is a life-threatening condition that can present with severe pain, swelling, and erythema of the affected area. It requires prompt recognition and treatment.
- Malignancy (e.g., vulvar cancer): Although unlikely in this scenario, it is essential to consider malignancy in the differential diagnosis, especially if the cyst does not respond to treatment or has atypical features.
- Rare diagnoses:
- Dermoid cyst: A rare type of cyst that can form on the labia, which can be hard and painful if it becomes inflamed or infected.
- Vulvar endometriosis: A rare condition where endometrial tissue forms on the labia, which can cause cyclic pain and swelling. However, this is unlikely given the acute onset of symptoms in this patient.