Diagnosis and Management of Genital Pruritus in Women

Vulvar pruritus is frustrating for the patient and the provider. This course is designed to help providers caring for women navigate the complicated and multifactorial nature of vulvar itching. It consists of a review of vulvar anatomy and delves into the more common causes of vulvar pruritus including contact dermatitis, lichen sclerosus, lichen simplex chronicus, and neuropathic itch. Clinical and distinguishing features of these diseases will be discussed in detail, along with appropriate steps in investigation and management. The course will cover evidence-based guidelines for the treatment of lichen sclerosus and expert opinions on how to address recalcitrant causes of itch such as lichen simplex chronicus as well as the most common causes of contact dermatitis. Tips and practical advice will be provided to help providers care for these patients. By the end of the course, providers should be aware of the safety of use of topical steroids on the vulva and potential pitfalls as well as when to refer patients for specialty care. 

Learning Objectives

• Evaluate normal vulvar anatomy
• Construct a differential diagnosis for the most common causes of vulvar itching based on morphological features (Contact dermatitis, lichen sclerosus and lichen simplex chronicus)
• Describe appropriate vulvar care and treatment strategies for common causes of itch and identify risks of topical steroids on the vulva
• Evaluate the symptoms and causes of neuropathic itch