CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Pruritus vulvae - Management
When should I refer a woman with pruritus vulvae?
- Referral to a dermatologist or gynaecologist with expertise in managing vulval disease is indicated if:
- The cause of the pruritus vulvae is unclear and symptoms persist:
- In most women an identifiable cause can be found.
- The urgency of the referral will depend on the nature of the symptoms and degree of concern (if any) about cancer.
- The cause is known, but symptoms persist despite primary care management:
- For example, some women with contact dermatitis may require referral to try and identify the irritant or allergen. If allergic contact dermatitis is suspected, then patch test investigations may be initiated.
- A premalignant condition, such as vulval intraepithelial neoplasia, lichen sclerosus, or lichen planus, is suspected:
- Accurate diagnosis is important because the woman may require long-term follow up. Women who require long-term follow up include those with troublesome ongoing symptoms, localized skin thickening, previous cancer, or vulval intraepithelial neoplasia.
- Specialist advice on management is often necessary.
- Urgent referral (within 2 weeks) is indicated if:
- Vulval carcinoma is suspected (for example if the woman has an unexplained vulval lump or ulcer).
© NHS Institute for Innovation and Improvement