Vulval pruritus and vaginal discharge

Vulval pruritus (itching of the vulva) and vaginal discharge are common complaints that many women will experience at least once in their lifetime. Patients will usually attend their usual doctor or general practitioner with these symptoms, but they are also often encountered in secondary care. An accurate diagnosis relies on a thorough history and examination. A vulval biopsy may be useful where there is any diagnostic uncertainty. Vaginal and endocervical swabs should be taken in cases of vaginal discharge. Causes of vulval pruritus and vaginal discharge fall broadly into the same general categories: infection, dermatoses, Vulval Intraepithelial Neoplasia (VIN) and malignancy. Appropriate investigations and treatments are discussed.