Differential Diagnosis for Suprapubic Itching in a 78-year-old Female
- Single most likely diagnosis:
- Contact dermatitis: This is the most likely diagnosis given the patient's history of shaving the pubic area a couple of days ago, which can cause irritation, especially in individuals with sensitive skin. The symptoms of redness and itching in the pubic area support this diagnosis.
- Other Likely diagnoses:
- Folliculitis: An inflammation of the hair follicles, which can occur after shaving and cause symptoms of redness, itching, and irritation.
- Ingrown hairs: These can cause itching, redness, and inflammation, especially in areas where the hair is curly or the skin is sensitive.
- Eczema (atopic dermatitis): Given the patient's report of sensitive skin, eczema could be a contributing factor to the itching and redness, especially if she has a history of the condition.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Cellulitis: A bacterial skin infection that can cause redness, swelling, and warmth of the skin. It's essential to consider this diagnosis, especially in elderly patients, as it can lead to severe complications if not treated promptly.
- Herpes simplex virus (HSV) infection: Although less common, HSV can cause itching, redness, and painful lesions in the genital area. Given the potential for serious complications, especially in immunocompromised individuals, it's crucial not to miss this diagnosis.
- Rare diagnoses:
- Lichen simplex chronicus: A condition characterized by chronic itching and scratching, leading to thickened skin. It's less common but could be considered if other diagnoses are ruled out.
- Psoriasis: An autoimmune condition that can cause red, scaly patches on the skin. Although it's less likely to present solely in the pubic area, it's essential to consider in patients with a history of psoriasis or other autoimmune conditions.