Clinical Care of Vulvar Pruritus, with Emphasis on One Common Cause, Lichen Simplex Chronicus
Section snippets
Vulvar pruritus
Vulvar pruritus is a common and distressing condition that affects nearly all women at some point in their lives. Vulvar pruritus describes an itch that feels good when scratched versus an itch that may be described as irritating, prickly, or burning. In the evaluation of vulvar pruritus, true itching is limited to a sensation that produces at least a desire to scratch or rub.
Patients with vulvar pruritus seek care from family practioners, gynecologists, internists, pediatricians, and
Lichen simplex chronicus
LSC of the vulva is one of the most common primary causes of vulvar pruritus and can be a secondary complication in any pruritic vulvar disease. LSC can be considered a localized, chronic variant of atopic dermatitis.25 Dermatologists consider eczema, atopic dermatitis, neurodermatitis, and LSC essentially as a continuum of the same disease process.
Primary LSC arises in normal-appearing skin and when occurring in the anogenital area may be referred to as “pruritus vulvae,” “pruritus scroti,” or
Summary
Vulvar pruritus can be caused by a wide spectrum of pathologies, the most common being candidiasis, contact dermatitis, LSC, and lichen sclerosus. LSC begins with an inciting itch sensation for which scratching and rubbing yield pleasure and relief, which can trigger a chronic itch-scratch cycle. The tendency toward LSC cannot be cured, but the symptoms generally can be controlled. Prompt treatment with superpotent corticosteroids usually breaks the itch-scratch cycle. Careful attention to
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