Differential Diagnosis for Burning Sensation between Labia

The patient's symptoms of a burning sensation between her labia could be attributed to various conditions. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Vulvar Dermatitis: This condition, which includes eczema (atopic dermatitis), is a common cause of burning sensations and itching in the vulvar area. Eczema can lead to inflammation, redness, and discomfort, matching the patient's symptoms.

• Other Likely Diagnoses

  • Vulvovaginal Candidiasis (Yeast Infection): Characterized by itching, burning, and abnormal discharge, yeast infections are a common issue in women and could easily cause the symptoms described.
  • Contact Dermatitis: An allergic reaction or irritation from soaps, douches, or other products can cause a burning sensation and itching in the vulvar area.
  • Lichen Sclerosus: A condition that creates patchy, white skin that's thinner than normal, leading to itching, burning, and pain, especially if the skin tears.

• Do Not Miss Diagnoses

  • Herpes Simplex Virus (HSV): Although less common, HSV can cause severe burning sensations, especially during outbreaks, and is crucial not to miss due to its implications for sexual health and the need for antiviral treatment.
  • Syphilis: In its primary stage, syphilis can cause a painless sore, but in later stages, it might lead to various symptoms including skin rashes and potentially burning sensations in the genital area, making it critical to diagnose early.
  • Vulvar Intraepithelial Neoplasia (VIN) or Vulvar Cancer: While rare, these conditions can cause persistent itching, burning, or pain in the vulvar area and are critical to diagnose early for effective treatment.

• Rare Diagnoses

  • Lichen Planus: An inflammatory condition that can affect the skin and mucous membranes, leading to itching, burning, and lesions in the vulvar area.
  • Vulvar Vestibulitis: Characterized by chronic pain and burning sensations in the vestibule of the vulva, this condition can significantly affect quality of life.
  • Neurological Disorders (e.g., Neuropathic Pain): In some cases, burning sensations can be related to nerve damage or disorders, which would be an uncommon but possible cause of the patient's symptoms.