Commonly the term pruritus vulvae is used as a diagnosis, though literally it describes only a symptom rarely seen without excoriation or dermatitis; seldom can the patient tell us which was the primary symptom. Unnecessary confusion results when the term is incorrectly applied, as in the presence of a distinctive dermatosis such as vulvar psoriasis or dermatomycosis. Dermatological experience minimizes this fault, which is commoner among general practitioners, gynecologists, and radiologists. There are various views on this disease, partly owing to the confusion of inaccurate terminology and partly to the viewpoints of the various specialists consulted by the patient, whose choice of physician has depended on the presence of vaginitis or discharge, urinary complaints, involvement of the perianal area, or extensive cutaneous inflammation. Because of such variations and because pruritus vulvae is fairly common and is frequently difficult to treat I have surveyed the literature of the past 10 years in other fields as well as in dermatology and reviewed the clinical manifestations in a series of 112 patients.
REVIEW OF LITERATUREDermatological texts list numerous causes for pruritus vulvae without agreement as to their relative importance : intertrigo, irritating discharges, diabetes, pregnancy, and others. Atopy is implicated by its frequent association with eczema as noted by some authors and by the occur¬ rence of lichenification. Special points of interest have been emphasized by one or several authors. 1. The vagina is not involved. 2. Pruritus vulvae in the absence of leukoplakia does not predispose to cancer nor relate to venereal disease (except gonorrheal discharge), but many pa¬ tients have such fears and deserve reassurance. 3. A pseudoleukoplakic appearance results from sodden graywhite maceration and may be difficult to differentiate from leukoplakia. It is the belief of Savill1 that gynecolo¬ gists often regard this as leukoplakia. In a monograph on vulvar disease Hunt devotes relatively little space to eczema, lichen simplex chronicus, or pruritus, and she
