PRURITUS, VULVAE

Ask the Following Questions:

1. Is there a vaginal discharge? The presence of a vaginal discharge should suggest candidiasis, trichomoniasis vaginitis, and bacterial vaginitis.
2. Is there a rash? The presence of a rash would suggest eczema, herpes simplex, folliculitis, scabies, and tinea infections.
3. Are there vulval or vaginal lesions? The presence of a lesion in the vulva or vagina would suggest kraurosis vulvae, leukoplakia or vulval carcinoma, condylomata lata, and condylomata acuminata.

DIAGNOSTIC WORKUP

If there is a discharge, microscopic examination of a potassium hydroxide preparation and saline preparation is necessary. A smear and culture of the discharge should be done for bacteria and fungi. Scrapings of the burrows for scabies may be useful. Skin biopsy may help diagnose the cause of a rash. Lesions should be biopsied also. If senile vaginitis is suspected, serum FSH and estradiol and a Pap smear may help determine if there is estrogen deficiency. A gynecologist should be consulted in all difficult diagnostic problems.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

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More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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