Differential Diagnosis for Intense Pruritis and Vaginal Swelling after Treatment

Single Most Likely Diagnosis

• Allergic Reaction: This is the most likely diagnosis given the symptoms of intense pruritis (itching) and vaginal swelling following a treatment. The treatment could have contained an allergen or irritant that triggered an allergic response, leading to these symptoms.

Other Likely Diagnoses

• Contact Dermatitis: This condition occurs when the skin comes into contact with an irritant or allergen, causing inflammation and leading to symptoms like pruritis and swelling. In the context of vaginal swelling, it could be due to a reaction to a product used in the treatment.
• Infection: Although less likely than an allergic reaction, an infection could develop after a treatment, especially if the treatment involved inserting instruments into the vagina or if the patient has a compromised immune system. Symptoms could include pruritis and swelling.
• Drug Reaction: If the treatment involved medication, a drug reaction could be a possible cause. Some medications can cause allergic reactions or side effects that include pruritis and swelling.

Do Not Miss Diagnoses

• Anaphylaxis: Although rare, anaphylaxis is a severe, life-threatening allergic reaction that requires immediate medical attention. Symptoms can include widespread itching, swelling, difficulty breathing, and a drop in blood pressure. It's crucial to consider anaphylaxis in any case of severe allergic reaction.
• Toxic Shock Syndrome (TSS): TSS is a rare but life-threatening medical condition caused by bacterial toxins. It can occur after certain medical treatments, especially those involving the vagina. Symptoms include fever, vomiting, diarrhea, abdominal pain, and rash, which might initially be mistaken for an allergic reaction or infection.

Rare Diagnoses

• Fixed Drug Eruption: A rare condition where a drug causes a skin reaction that recurs at the same site each time the drug is taken. It could potentially cause localized pruritis and swelling if the reaction occurs in the vaginal area.
• Stevens-Johnson Syndrome (SJS) / Toxic Epidermal Necrolysis (TEN): These are rare, serious disorders of the skin and mucous membranes, usually triggered by medications or infections. They can cause widespread skin lesions, blisters, and peeling, along with other systemic symptoms. While rare, they are medical emergencies and should be considered in severe cases of skin reactions.