What is the diagnosis for a left vulvar pea-sized firm cyst with mild erythema, tender to touch, and no fluctuant center?

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Differential Diagnosis for Left Vulva Cyst

  • Single most likely diagnosis
    • Bartholin's cyst or abscess: The presence of a pea-sized firm cyst with mild erythema and tenderness to touch on the vulva is highly suggestive of a Bartholin's cyst or abscess, especially given the location and symptoms.
  • Other Likely diagnoses
    • Sebaceous cyst: A sebaceous cyst could present as a firm, tender nodule on the vulva, although it might not typically have the same level of erythema as a Bartholin's cyst.
    • Epidermal inclusion cyst: Similar to a sebaceous cyst, an epidermal inclusion cyst could appear as a firm, possibly tender cyst on the vulva.
    • Folliculitis or furuncle: An infected hair follicle (folliculitis) or a more severe infection forming a boil (furuncle) could present with similar symptoms, including tenderness and erythema.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • Necrotizing fasciitis: Although rare, necrotizing fasciitis is a life-threatening condition that could initially present with similar symptoms of erythema, tenderness, and swelling. Early recognition is crucial.
    • Malignancy (e.g., vulvar cancer): While less common, any new or persistent vulvar lesion should be evaluated for the possibility of malignancy, especially in older adults or those with risk factors.
  • Rare diagnoses
    • Hydrocele of the vulva: A condition where a fluid-filled cyst forms in the vulva, which could potentially present similarly but is less common.
    • Mesonephric cyst: A rare congenital anomaly that could present as a cystic structure on the vulva.
    • Adnexal tumor: Tumors of the adnexal structures (sweat glands, sebaceous glands) of the vulva could present as firm, possibly tender masses, but are less common.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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