Chronic vulvar itch: diagnostic and therapeutic challenges

Vulvar pruritus refers to itching affecting the skin and mucosal surfaces of the external genital and perineal regions. It is most frequently associated with infections, inflammatory skin disorders, or neoplastic conditions. Due to the distinctive anatomical and physiological features of the anogenital area, clinical manifestations in this region are often subtle or atypical, which can complicate both diagnosis and management. Because vulvar itch can be highly distressing, timely identification and appropriate intervention are crucial for improving patient quality of life. A comprehensive clinical approach is essential when evaluating patients with vulvar pruritus. This includes a detailed medical history, focused physical examination, and relevant diagnostic testing. Management should involve elimination of contributing or exacerbating factors and treatment directed at the underlying cause. This review article discusses the common causes of vulvar pruritus, emphasizing the diagnostic approach and outlining current treatment strategies. The importance of an individualized patient-centered management plan is emphasized.