Differential Diagnosis
- Single most likely diagnosis
- Allergic contact dermatitis: This is the most likely diagnosis given the patient's history of reacting to different types of cotton and the presence of vaginal itching without any odor or discharge. The use of an abnormally panty liner may be exacerbating the condition.
- Other Likely diagnoses
- Irritant contact dermatitis: Similar to allergic contact dermatitis, irritant contact dermatitis could be caused by the panty liner or other hygiene products, leading to vaginal itching.
- Atopic dermatitis (eczema): The patient's history of ureaplasma infection may not be directly related, but atopic dermatitis can cause itching and skin irritation in the vaginal area.
- Vulvar lichen simplex chronicus: This is a condition characterized by chronic itching and scratching of the vulvar area, which could be related to the patient's symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lichen sclerosis: Although rare, lichen sclerosis is a condition that can cause itching and skin thinning in the vulvar area. If left untreated, it can increase the risk of vulvar cancer.
- Invasive cancer: Although unlikely in a 35-year-old woman, any persistent or unexplained vaginal symptoms should prompt an evaluation for invasive cancer.
- Stevens-Johnson syndrome: This is a rare but life-threatening condition that can cause skin and mucous membrane lesions, including in the vaginal area.
- Rare diagnoses
- Vulvar intraepithelial neoplasia: This is a rare precancerous condition that can cause itching and skin changes in the vulvar area.
- Dermatologic conditions like psoriasis or seborrheic dermatitis: These conditions can cause skin lesions and itching in the vaginal area, although they are less common in this location.