“A Clinical Study of Pruritus Vulvae Among Sexually Transmitted Infections Clinic Attendees in a Tertiary Care Hospital”

Background: Vulval pruritus affects the patients' quality of life, and many are being treated with placebo drugs just to relieve the symptoms and subsequently there are innumerable patients suffering from this embarrassing condition with no prime treatment. Hence, there is a need to identify the aetiology and confirm the diagnosis of pruritus vulvae with several investigations for appropriate treatment and to tackle the misery and stress of such patients. This is a cross-sectional observational study in females aged >12 years attending STI Methodology: clinic in Tirunelveli Medical College for 18 months (January 2018 to June 2019). All the included patients underwent a complete genital examination and patients with vaginal discharge were investigated with KOH mount, gram's stain, wet mount examination, whiff test and culture with SDA. Routine screening for sexually transmitted diseases like syphilis, HIV, HBsAg and HCV were done. Routine blood investigations like CBC, RBS, RFT, LFT, urine routine were done to rule out systemic conditions associated with pruritus. Descriptive statistical analysis was used in percentages and chi square test with p<0.05 were used for test of significance for comparisons. Results: Among 225 cases of pruritus vulvae, the most common age group encountered in our study was 40-64 years (53.3%). In the study, most common infective aetiology encountered with pruritus vulvae was VVC (57.3%) followed by intertrigo (19.1%). The most common non-infective aetiology was lichen sclerosus et atrophicus (10.2%) followed by lichen simplex chronicus (0.4%). Prevalence of diabetes and HIV was 12% and 8% respectively. Conclusion: Vulvovaginal candidiasis is the most common diagnosis associated with pruritus vulvae in our study. Proper health education of vulvovaginal hygiene must be promoted for prevention of STI's associated with pruritus vulvae. Also, there is a need for prompt diagnosis and management of pruritus vulvae which is an extremely troublesome condition to the patients.