Differential Diagnosis for Vaginal Itching
Single Most Likely Diagnosis
- Vulvovaginal Candidiasis: This is the most common cause of vaginal itching, often resulting from an overgrowth of Candida albicans. It is characterized by intense itching, redness, and a white, clumpy discharge.
Other Likely Diagnoses
- Bacterial Vaginosis (BV): BV is another common condition that can cause vaginal itching, along with an abnormal vaginal discharge and odor. It results from an imbalance of the normal bacterial flora in the vagina.
- Vaginal Atrophy: This condition, often seen in postmenopausal women, leads to thinning and drying of the vaginal walls, causing itching, burning, and pain during intercourse.
- Allergic Contact Dermatitis: This can occur due to an allergic reaction to soaps, douches, condoms, or other products that come into contact with the vagina, leading to itching, redness, and sometimes a rash.
- Trichomoniasis: A sexually transmitted infection caused by the parasite Trichomonas vaginalis, which can cause itching, burning, redness, and a frothy, foul-smelling discharge.
Do Not Miss Diagnoses
- Lichen Sclerosus: A chronic skin condition that can cause significant itching and discomfort. If left untreated, it can lead to scarring and increased risk of vulvar cancer.
- Vulvar Intraepithelial Neoplasia (VIN) or Vulvar Cancer: Although rare, these conditions can present with persistent itching and should be considered to ensure early detection and treatment.
- Herpes Simplex Virus (HSV): Genital herpes can cause itching, along with painful blisters or ulcers. It's a sexually transmitted infection that requires antiviral treatment.
Rare Diagnoses
- Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by intense vaginal inflammation and itching, often with a purulent discharge.
- Vaginal Eczema (Atopic Dermatitis): Eczema can affect the vagina, leading to itching, redness, and sometimes a rash.
- Psoriasis: Although more commonly associated with skin lesions elsewhere on the body, psoriasis can occasionally affect the vulva, causing itching and redness.
- Lichen Planus: A rare condition that can affect the mucous membranes, including the vagina, leading to itching, pain, and sometimes a white, lacy pattern on the skin.