Differential Diagnosis for Hard Swollen Labia

• Single most likely diagnosis
  • Bartholin's cyst or abscess: This is a common condition that can cause swelling and hardness of the labia due to the accumulation of fluid or infection in the Bartholin's gland, which is located near the vaginal opening.
• Other Likely diagnoses
  • Vulvar cellulitis: An infection of the skin and tissues of the vulva, which can cause swelling, redness, and hardness.
  • Vulvar edema: Swelling of the vulva, which can be caused by a variety of factors, including infection, allergy, or trauma.
  • Lipoma or cyst: A benign growth that can cause swelling and hardness of the labia.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Necrotizing fasciitis: A rare but life-threatening infection that can cause swelling, redness, and hardness of the vulva, and requires prompt medical attention.
  • Malignancy (e.g., vulvar cancer): Although rare, cancer of the vulva can cause swelling and hardness of the labia, and is important to rule out.
• Rare diagnoses
  • Lymphogranuloma venereum (LGV): A sexually transmitted infection that can cause swelling and hardness of the labia, as well as other symptoms such as fever and lymphadenopathy.
  • Crohn's disease or ulcerative colitis: Inflammatory bowel diseases that can cause vulvar swelling and hardness, among other symptoms.
  • Sarcoidosis: A rare autoimmune disease that can cause swelling and hardness of the labia, as well as other symptoms such as skin lesions and lung disease.