What is the reason for external genital itching? How to differentiate and diagnose external genital eczema

The appearance of external genital eczema is particularly distressing for many women, and it has a serious impact on patients. We need to understand its symptoms and pay attention to reasonable differential diagnosis, and do a good job of prevention in daily life.

Symptoms of external genital eczema

Female genital eczema often occurs in the labia minora and sulcus of the genitalia. The course of the disease is variable, the onset is irregular, and the symptoms are not obvious. When going to bed or feeling nervous, severe itching may occur. The accompanying itching can be secondary infection after scratching, with local redness and small pus spots in the center of some rashes.

The acute stage of external genital eczema mainly manifests as severe itching and diffuse flushing of the external genitalia. The skin damage is pleomorphic without obvious boundaries, and the condition further develops. The surface of the skin presents needle sized papules, papules or small blisters, congestion at the base, unclear damage boundaries, progressive erosion, edema, and worsening exudation.

Scratching due to scorching heat and severe itching can damage the epidermis, leading to infection and scabbing. It can also be accompanied by symptoms such as enlarged inguinal lymph nodes, fever, and general discomfort. If not treated properly, repeated attacks can prolong the course of the disease and turn into chronic diseases.

In the chronic stage of external genital eczema, due to repeated scratching, there may be a small amount of serous exudation at the scratch site, which can cause infiltration and hypertrophy in the epidermis and dermis. The skin is rough and may have mossy like sclerosis with clear boundaries. The surface often has furfural like scales, which are hard to touch or have moist scabs. In severe cases, cracking can occur, and there is pain during movement. Due to blood scabs and pigmentation, the skin is brown or depigmented.

Differential diagnosis of external genital eczema

1. Acute eczema needs to be distinguished from contact dermatitis of the external genitalia.

2. Chronic eczema needs to be distinguished from neurodermatitis vulvar pruritus.

3. Keratosing eczema should be distinguished from psoriasis. Psoriasis has no exudative skin lesions with clear boundaries and is covered with silver white scales.

4. Differentiation from female mucosal leukoplakia: Female mucosal leukoplakia is seen in women over 40 years old. The damage mainly affects the clitoris, labia minora, and labia majoris mucosa, with grayish white patches accompanied by excessive keratinization and severe itching.

5. Identification of eczema infection: Eczema infection often has clear boundaries and circular edges. Small pustular skin lesions can be seen as erythema, exudate, and scabs. The scab is yellow and oily, and the bright red erosive surface is below the scab. In the wrinkled area, eczema infections often form cracks.