Vaginitis, Colpitis: Or something else? Differential Diagnosis

Since the differential diagnoses according to ICD 10 are partly not recorded, e.g., burning, vesicles, or only unclear, and are not clinically practicable to present, a differential diagnosis under clinically relevant aspects according to symptoms is presented under the item “Further”, whereby a strict separation between vulva (totality of the external primary sexual organs) and vagina (vagina) is not possible and also not meaningful. Endocrine, nutritional, and metabolic diseases (E00-E90).

• Estrogen deficiency (especially in children and postmenopausal).

Skin and subcutaneous (L00-L99).

• Lichen ruber/ planus (nodular lichen).
• Pemphigus vulgaris (blistering skin disease).
• Psoriasis (psoriasis)
• Dermatitis (inflammatory reaction of the skin)

Infectious and parasitic diseases (A00-B99).

• Chlamydia
• Gonorrhea (gonorrhea)
• Genital herpes
• Herpes zoster
• Mites
• Mycoses
• Molluscum cotagiosum
• Pemphigus vulgaris
• Phthiriasis (crabs)
• Scabies (scabies)
• Staphylococcus aureus
• Streptococcus group A, B
• Syphilis
• Trichomonads
• Varicella (chickenpox)
• Vulvitis plasmacellularis

Musculoskeletal system and connective tissue (M00-M99)

• Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the corpus ciliary (corpus ciliare) and the iris) is stated as typical for the disease; a defect in cellular immunity is suspected

Neoplasms – tumor diseases (C00-D48).

• Cervical carcinoma (cervical cancer).
• Corpus carcinoma (cancer of the body of the uterus)
• Tubal carcinoma (fallopian tube cancer)
• Vaginal carcinoma (cancer of the vagina)
• Vulvar carcinoma (vulvar cancer; cancer of the external genital organs of women).

Psyche – Nervous System (F00-F99; G00-G99).

• Depression
• Partner conflict
• Psychosomatic disorders – especially in sexual conflicts (sexual disorder).

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

• Adnexitis – inflammation of the so-called adnexa (Eng. : appendage formation); combination of inflammation of the tubes (Latin tuba uterina, Greek salpinx, inflammation: salpingitis) and ovaries (Latin ovary, Greek oopheron, inflammation: oophoritis).
• Cervicitis (inflammation of the cervix).
• Cervical ectopy – displacement (ectropion) of glandular mucosa of the cervix in the vaginal part of the cervix (partial); normal finding during sexual maturity.
• Cervical polyp – benign mucosal tumor originating from the cervix.
• Cervical tear – tear on the cervix.
• Endometritis (inflammation of the uterus)
• Corpus polyp – growths of the endometrium.
• Pyometra – purulent inflammation of the uterus.
• Infections caused by:
  • Bacteria
  • Parasites
  • Fungi
  • Protozoa
  • Viruses

Injuries, poisonings and other consequences of external causes (S00-T98).

• Foreign body colpitis
• Sexual abuse
• Special sexual practices
• Allergic, toxic effects of soaps, detergents, etc

.

Differential diagnoses according to symptoms

Vesicles:

• Infections
  • Genital herpes
  • Herpes zoster
  • Varicella (vulva)
• Dermatoses
  • Herpes gestationis
  • Pemphigus vulgaris (vulva)
  • Toxic allergic dermatitis (e.g., drugs, detergents, insecticides, cosmetics, oils, conditioners, detergents).

Burning:

• Infections
  • Genital herpes
  • Herpes zoster
  • Streptococcus group A
  • Trichomonads
  • Vulvitis plasmacellularis
• Dermatoses
  • Behçet’s disease
  • Lichen ruber/ planus erosivus
  • Pemphigus vulgaris
• Other
  • Skin injury
  • Irritative (allergic) dermatitis
  • Toxic contact dermatitis (e.g., drugs, detergents, insecticides, cosmetics, oils, rinses, washovers, detergents).

Areal redness:

• Infections
  • Fungi
  • Streptococcus group A
  • Trichomonads
  • Vulvitis plasmacellularis
• Dermatoses
  • Lichen ruber/ planus erosivus
  • Lichen sclerosus (scratch marks)
  • Pemphigus vulgaris
  • Psoriasis
• Other
  • Irritative (allergic) dermatitis
  • Toxic contact dermatitis (e.g., pharmaceuticals, detergents, insecticides, cosmetics, oils, conditioners, detergents).

Fluorine vaginalis:

• Bacterial vaginosis
  • Consistency: thin
  • Color: white-gray
  • Odor: fishy
• Chlamydia
  • Consistency: medium
  • Color: glassy-clear
  • Odor: none
• Foreign body
  • Consistency: thin-to-viscous
  • Color: brownish
  • Odor: malodorous
• Gonorrhea
  • Consistency: creamy
  • Color: yellowish-purulent
  • Odor: malodorous
• Carcinoma
  • Consistency: watery
  • Color: brown-bloody
  • Odor: putrid
• Mushrooms
  • Consistency: creamy-cheesy
  • Color: whitish-yellow
  • Odor: none
• Parasites
  • Consistency: thin-liquid
  • Color: yellowish-clear
  • Odor: none possibly musty
• Trichomonads
  • Consistency: foamy
  • Color: green-yellow
  • Odor: fetid, malodorous

Nodule:

• Infections
  • Acne inversa (vulva)
  • Folliculitis (vulva)
  • Genital herpes
  • Molluscum contagiosum (vulva)
  • Fungi
  • Syphilis (vulva)

Without (hardly) complaints:

• Infections
  • Erythrasma (vulva)
  • Condyloma (HPV)
  • Molluscum contagiosum (vulva)
  • Syphilis (vulva)

Pruritus (itching):

• Infections
  • Candida
  • Lice (vulva)
  • Scabies (scabies) (vulva)
  • Trichomonads
• Dermatoses
  • Lichen sclerosus (vulva)
  • Lichen ruber/planus
  • Lichen simplex (vulva)
  • Psoriasis
• Other
  • Irritative (allergic) dermatitis
  • Scratch marks
  • Toxic contact dermatitis (e.g., pharmaceuticals, detergents, insecticides, cosmetics, oils, rinses, washovers, detergents).
  • Injuries

Pustules:

• Infections
  • Folliculitis (vulva)
  • Genital herpes
  • Herpes zoster (vulva)
  • Fungi (vulva)
  • Varicella (vulva)

Pain:

• Infections
  • Acne inversa (vulva)
  • Abscess (encapsulated collection of pus)
    • Bartholinic pseudoabscess (vulva)
  • Folliculitis (vulva)
  • Genital herpes
• Dermatoses
  • Behçet’s disease
• Other
  • Skin lesion/scratch marks (vulva).
  • Irritative (allergic) dermatitis
  • Toxic contact dermatitis (e.g., drugs, detergents, insecticides, cosmetics, oils, rinses, washovers, detergents).

Ulcers (ulcers):

• Infections
  • Genital herpes
  • Syphilis (vulva)
  • Ulcus molle (vulva)
• Dermatoses
  • Behçet’s disease
  • Lichen ruber/planus
  • Lichen sclerosus (scratch marks) (vulva)
• Other
  • Vaginal ulcer due to pessary
  • Sexual abuse
  • Special sexual practices