Etiologies of vulvovaginal disorders

Edema and erythema may be present with many different conditions and multiple conditions must be considered at all times. This list is not exhaustive, but is constructed to show another way to organize thinking when considering women’s vulvovaginal complaints.

BENIGN CONDITIONS:
There can be papules, nodules, or pigmentary changes that occur without health risk and often without symptoms. These include:
Achrocorda
Angiomas
Angiokeratomas
Cysts
Fibroepithelial polyps
Fordyce spots
Genital melanosis
Keratosis pilaris
Lentigenes
Lipomas
Neurofibromas
Nevi
Seborrheic keratosis
Syringoma
Vestibular papillomatosis
Urethral caruncle
Sweat gland tumors: hidradenoma papilliferum
Pyogenic granulomas

DISORDERS:

Infectious etiologies:

Bacterial

Bacterial super-infection
Cellulitis
Chlamydia
Erythrasma
Folliculitis
Furunculosis
Gonorrhea
Impetigo
MRSA
Syphilis
Toxic shock
(Other STIs)

Viral

Herpes simplex
Herpes zoster
HIV related ulcers
Human papillomavirus (condyloma, VIN)
Molluscum contagiosum

Fungal

Candida Albicans and other forms of yeast
Dermatophyte (fungal) infection

Protozoal

Trichomoniasis

Disturbance of normal flora

Bacterial vaginosis

Irritant, allergic, or drug reaction:

Irritant reaction
Allergic reaction
Drug reaction
Fixed drug eruption
Intertrigo
Seminal plasma allergy

Dermatitis:

Eczema/Lichen simplex chronicus

Dermatosis

Psoriasis
Lichen Sclerosus
Lichen Planus
Plasma cell vulvitis

Hormonally mediated:

Atrophy related to low estrogen from aging, postpartum period, lactation, amenorrhea
Autoimmune progesterone dermatitis

Neuropathic disturbances and pelvic floor dysfunction:

Vulvodynia or generalized vulvar pain
Other pain conditions such as fibromyalgia, migraine, chronic pelvic pain, musculoskeletal disorders

Systemic, autoimmune, or genetic disease:

Behçet disease
Crohn or other inflammatory bowel disease,
Pemphigus and pemphigoid
Vitiligo

Pre-cancer or cancer:

VIN
Melanoma
Squamous cell carcinoma
Basal cell carcinoma

Immunosuppression

Yeast is more likely

Trauma or socially related conditions

Infestations
Scabies
Pediculosis
Surgical, obstetrical, or treatment-related trauma
Hematomas
Radiation reactions
Surgical scarring
Female genital cutting
Self inflicted trauma
Prurigo nodularis

Conditions of unknown source:

Aphthous ulcers
Extramammary Paget Disease