Vulval itch. (1/9)

BACKGROUND: Vulval itch is common. Patients presenting with this symptom can have a long history involving visits to several general practitioners. Self diagnosis as thrush is common, and inappropriate use of over-the-counter antifungal preparations can lead to further irritation and distress. Excoriation, rubbing, maceration, secondary infection and the effects of topical applications frequently complicate matters. OBJECTIVE: This article identifies the common causes of vulval itch in adults and children, and highlights key features of the diagnosis and management of these conditions. Vulval pain syndromes are beyond the scope of this article and are therefore not discussed. DISCUSSION: The cause of vulval itch can often be multifactorial, but with careful assessment, a primary diagnosis can be reached in most cases. A good history requires patience, and gentle direct questioning, as patients often feel uncomfortable discussing their problems and may not disclose self applied remedies. Care should be taken during examination, as vulval rashes may be subtle. All postpubertal patients should have a low vaginal swab to diagnose candidiasis rather than treating empirically.  (+info)

Chronic vulvovaginal pruritus treated successfully with GnRH analogue. (2/9)

A Medline search shows that this is the first reported case where vulvovaginal pruritus was treated successfully with a GnRH analogue. The report describes a patient with chronic premenstrual vulvovaginal pruritus thought to be attributable to autoimmune progesterone dermatitis.  (+info)

Determination of iron status in women attending genitourinary clinics with pruritus vulvae. (3/9)

OBJECTIVE: To compare iron status in women with pruritus vulvae and in asymptomatic controls. METHODS: 42 women with pruritus vulvae and 42 asymptomatic broadly age-matched controls were enrolled in this prospective study. The outcome measures assessed were serum iron, serum ferritin, total iron-binding capacity, haemoglobin and transferrin saturation. RESULTS: 12 (29%) participants and 10 (24%) controls were iron deficient; 1 (2%) participant and 1 (2%) control had laboratory-defined iron deficiency anaemia. Participants generally had lower levels of iron markers than controls, with differences (95% confidence interval (CI)) of -3.5 microg/l (-9.89 to 6.99) for serum ferritin (p = 0.73), -4.9 mmol/l (-8.12 to 0.12) for serum iron (p = 0.06) and -5.5 mmol/l (-5.75 to 1.46) for total iron-binding capacity (p = 0.24). No significant difference in haemoglobin or mean cell volume was shown between the two groups (haemoglobin: p = 0.17, 95% CI -0.83 to 0.15; mean cell volume: p = 0.15, 95% CI -4.59 to 0.73). CONCLUSION: This study does not provide evidence to support the routine determination of iron status in patients presenting to genitourinary medicine clinics with pruritus vulvae from all causes.  (+info)

Vulvar pruritus and burning sensation in women with psoriasis. (4/9)

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Vulvar puritus for one year. (5/9)

A 60-year-old menopausal female presented with vulvar itching for one year. She had noticed a whitish lesion on the vulva that slowly increased in size over the year. She had been unsuccessfully treated with oral fluconazole and topical clotrimazole-mometasone combinations and the plaque had gradually spread to involve the clitoris and peri-urethral area. She was neither diabetic nor hypertensive and had no other systemic complaints. Examination revealed a well-defined non-tender whitish plaque situated on her left labia minora and clitoris (Figure 1). A swab from the plaque did not grow any organism. Routine blood chemistry including a VDRL and HIV ELIZA were within normal limits. A punch biopsy from the lesion was taken and histopathology findings were as seen in (Figures 2 and 3).  (+info)

The impact of the latest classification system of benign vulvar diseases on the management of women with chronic vulvar pruritus. (6/9)

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Overview of treatment of vulvovaginal disease. (7/9)

Vulvovaginal diseases commonly are inadequately diagnosed and treated. Most are dermatologic, but can be atypical in presentation in the warm, moist genital area. There is limited training or education for medical caregivers for these conditions. The first step is correct diagnosis, which requires time and knowledge of the normal anatomy, and careful examination. Dermatologists are invaluable for management as they recognize skin problems and can correct barrier function, control inflammation, and address itching and pain.  (+info)

Vaginal microbial flora in normal young women. (8/9)

Vaginal swabs were taken from 1498 women attending a family planning clinic. The flora was assessed in the absence of any information about the women to whom the swabs related. Yeasts and fungi were present in 311 women (21%) and were no more prevalent among "pill" users than others. Candida albicans was significantly associated with vulval itching and with a vaginal discharge described as heavier than normal or curdy on clinical examination, though these abnormalities were present in only a minority of women with the organism. Trichomonas vaginalis was found in 14 women (1%) and was associated with abnormalities of vaginal discharge in all but one. Gram-negative anaerobic bacilli were significantly more common in women with a troublesome vaginal discharge and those who used an intrauterine device than others. No associations were found between fungi other than C albicans or the other bacteria sought and either symptoms or clinical abnormalities of vaginal discharge.  (+info)