Vulval pruritus: The experience of gynaecologists revealed by biopsy

Abstract

Pruritus of the vulva is a common symptom among patients attending to outpatient clinics. In the present study, we aimed to assess pathologies causing vulval pruritus in the reliability of biopsy in a tertiary referral centre. A total of 137 patients undergoing vulval colposcopy because of vulval pruritus were reviewed from the hospital records retrospectively. The mean age of the patients was 47.61 ± 11.88 years and 36.5% of the patients were postmenopausal. In 101 (73.7%) of the patients, macroscopic lesions were present. In 88 (64.2%) of the patients, tolidine-positive stained areas were determined under colposcopy. In total, 68 (49.6%) of the lesions were plain, whereas 51 (37.2%) of them were depigmented. Lichen simplex chronicus, lichen sclerosis and chronic inflammation were the major pathologies associated with vulval pruritus (25.5%, n = 35; 20.4%, n = 28; 14.6%, n = 20). In conclusion, several pathologies out of vulvovaginal candidiasis may lead to vulval pruritus and clinicians should be aware of the importance of biopsy in determining the underlying pathology.

A study of genital pruritus in female patients attending the dermatology OPD at a tertiary care center in South Rajasthan

“…5 In Ozalp et al study, while 56.9% of the patients had an acute itch, 43.1% had chronic. 8 In a study by Bedell et al the average duration of itch was 2 years. 9 Itch alone was seen in 40.3% of our patients while 59.7% had itch associated with other sensations like burning and pain.…”

“…This is similar to the study by Ozalp et al where itch alone was seen in 41.6% of the patients and associated sensations like burning and pain in 43.8%. 8 Bedell et al found that 59% of the patients were found to have itch alone as the primary complaint whereas additional symptoms were seen in 41%. 9 Vulval pruritus can be associated with other symptoms of vulval irritation (VI) which includes a sensation of irritation, chafing, pain and burning.…”

“…This is similar to a number of other studies conducted on female genital itch. 3,5,8,9 Involvement of adjacent regions like the perianal skin and groin was seen in 9.2% of the patients.…”

Neuropathic itch treated with oral cannabinoids: A case series

“…Although most cases of vulvar itch can be attributed to infectious causes or inflammatory dermatoses, such as psoriasis, lichen simplex chronicus, lichen sclerosus, or contact dermatitis, some cases of chronic vulvar itch can be categorized under the umbrella of genitofemoral neuralgia or vulvodynia. 3 Classically regarded as a type of neuropathic pain, itch and burning can accompany vulvodynia in 20% and 70% of cases, respectively, 4 and are similarly addressed in the same way with medications targeting neurogenic pathways.…”

Vulvanın Benign Hastalıklarının Tanı ve Tedavisi

“…Isı, nem ve sürtünme vulvar cildin bariyer fonksiyonunu zayıflatarak irritasyona neden olur 1 . Kaşıntı, ağrı, disparoni gibi vulvar semptomlar oldukça sık görülmekle birlikte kimi zaman hastanın şikayetini dile getirmekten çekinmesi, kimi zaman da biz hekimlerin semptomlara yeterince önem vermemesi nedenleriyle göz ardı edilmektedir 2 . Vulvanın olağan günlük bakımına dair öneriler Tablo 1'de özetlenmiştir.…”