Differential Diagnosis for Vulvar Swelling and Pain
Single Most Likely Diagnosis
- Contact Dermatitis: This is a common condition that can cause vulvar swelling and pain, often due to an allergic reaction to soaps, detergents, or other irritants. The symptoms can include redness, itching, and burning sensations, which align with the description provided.
Other Likely Diagnoses
- Vulvar Vestibulitis: Characterized by chronic pain and inflammation of the vulvar vestibule, this condition can cause significant discomfort and swelling. It may be related to allergic reactions, infections, or other factors.
- Urinary Tract Infection (UTI): While not exclusively an allergic reaction, UTIs can cause vulvar swelling and pain due to the proximity of the urinary tract to the vulva. Symptoms can include burning during urination, frequent urination, and pelvic pain.
- Vulvar Eczema (Atopic Dermatitis): This condition involves inflammation of the vulvar skin, leading to itching, redness, and sometimes swelling. It can be managed with topical corticosteroids and avoiding irritants.
Do Not Miss Diagnoses
- Necrotizing Fasciitis: Although rare, this is a life-threatening condition that requires immediate medical attention. It involves a severe infection of the tissue beneath the skin, including fat and the tissue covering the muscles (fascia), which can lead to necrosis.
- Bartholin's Gland Abscess: An abscess of the Bartholin's gland can cause significant pain and swelling on one side of the vulva. It's usually caused by a bacterial infection and may require drainage.
- Herpes Simplex Virus (HSV) Infection: Genital herpes can cause painful blisters or ulcers, swelling, and redness in the genital area, including the vulva. It's a sexually transmitted infection that can have serious implications if not managed properly.
Rare Diagnoses
- Lichen Sclerosus: A rare condition that creates patchy, white skin that's thinner than normal. It can cause itching, pain, and swelling in the vulvar area.
- Lichen Planus: An inflammatory condition that can affect the skin and mucous membranes, leading to purplish, itchy, flat bumps. In the vulvar area, it can cause significant discomfort and changes in skin texture.
- Vulvar Cancer: Although very rare, any persistent or unexplained vulvar swelling and pain should be evaluated for the possibility of cancer, especially in older women or those with a history of HPV infection.
For management, topical corticosteroids, antihistamines for allergic reactions, and avoiding irritants can be beneficial. In cases of infection, appropriate antibiotics or antiviral medications may be prescribed. It's crucial to consult a healthcare provider for a proper diagnosis and treatment plan.