Differential Diagnosis for Vulvar Itching
Single Most Likely Diagnosis
- Candidiasis (Vulvovaginal Yeast Infection): This is often the most common cause of vulvar itching due to the prevalence of yeast infections in the female population. The itching is usually accompanied by a white, cottage cheese-like discharge and redness.
Other Likely Diagnoses
- Contact Dermatitis: This can occur due to irritation from soaps, douches, or other products that come into contact with the vulvar area, leading to itching and sometimes a rash.
- Lichen Sclerosus: A chronic inflammatory skin condition that can cause itching, pain, and white patches on the vulva.
- Lichen Planus: An autoimmune condition that can affect the skin and mucous membranes, leading to vulvar itching, pain, and sometimes erosions.
- Atopic Dermatitis (Eczema): Can affect the vulvar area, causing itching, redness, and sometimes small bumps.
Do Not Miss Diagnoses
- Squamous Cell Carcinoma or Other Vulvar Cancers: Although rare, vulvar cancer can present with itching as an early symptom. Missing this diagnosis could be fatal, making it crucial to consider, especially in postmenopausal women or those with a history of HPV.
- Herpes Simplex Virus (HSV): Can cause severe itching, along with painful blisters or ulcers. It's essential to diagnose and treat to prevent complications and transmission.
- Syphilis: A sexually transmitted infection that can cause a variety of symptoms, including itching in its early stages, and can have severe consequences if left untreated.
Rare Diagnoses
- Vulvar Intraepithelial Neoplasia (VIN): A precancerous condition that can cause itching and is often associated with HPV infection.
- Paget's Disease of the Vulva: A rare form of vulvar cancer that presents with itching and a rash.
- Zinc Deficiency: Can lead to skin lesions and itching in various parts of the body, including the vulva.
- Psychogenic Causes: Such as vulvodynia, where the itching may be related to psychological factors rather than a physical cause.