Management of vaginal itching
Vaginal itching
Diagnosis of Vaginal itching
Treatment of vaginal itching.
Causes of Vaginal itching
Causes of vaginal itching :
Pruritus associated with vaginal discharge :
- Trichomonas vaginalis.
- Candida albicans.
Pruritus without vaginal discharge :
- Local skin lesions : Psoriasis, Seborrhoeic dermatitis, Intertigo.
- Infections of the vulva : Candida, Herpes genitalis, scabies, Gonorrhoea, Trichomoniasis, Pediculosis, genital warts.
- Allergic or contact dermatitis : Use of Nylon under – garments.
- Non – Neoplastic epithelial disorders of vulva : Squamous hyperplasia, Lichen sclerosis.
- Neoplastic epithelial disorders of vulva : VIN, Pagets disease.
- systemic disease : Example
- Glycosuria
- Thyroid disorders
- Chronic liver disease
- contact dermatitis
- Drug allergy
- Deficiency of iron
- Deficiency of folic acid
- Deficiency of vitamin B12
- Mental anxiety
- Sexual frustration.
Management of a young women with itching vulva :
Diagnosis :
Detailed History :
- Age of onset of pruritus
- Intensity of itching
- Duration of itching
- Associated vaginal discharge
- Contraceptive practice
- Relation with psychological upset or neurosis.
- Allergy to nylon, soap or particular detergents.
General examination :
- Through systemic examination is needed.
- Examination of DM, liver & thyroid disorders, haematological diseases are to be made.
Local examination : To see the extent of lesion.
Investigations of Vaginal itching :
- Microscopic examination of vaginal discharge.
- Vulvar scraping to detect Candid or Trichomonas vaginalis.
- Urine for sugar, protein & pus cells .
- Liver function tests
- Renal functions tests
- Stool Look for ova, parasites & cyst.
- Blood:
- CBC
- Postprandial glucose
- Detailed haematological work up (polycythemia, leukaemia)
- Thyroid profile.
Treatment of Vaginal itching :
- Proper explanation and reassurance.
- Appropriate local hygiene is to be maintained.
- To wear loose fitting cotton underclothes & keeping of the vulva well aerated by day & night.
- Regular physical exercise and rest.
- Correction of anaemia by iron and vitamins.
- Vulvo-vaginal douching is to be avoided.
- To prevent the itching-oral antihistamine.
- To prevent the vicious cycle of “itch-scratch”:
- Local application of antibiotics or clobesterol propionate 0.05%.
- If the skin is atrophic, estrogen or testosterone cream.
Specific treatment of Vaginal itching : According to cause.
Surgery of Vaginal itching : Surgery may be needed when biopsy confirms the features of neoplasia (VIN or invasion).
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