Common Causes
- Genital Scabies & Pubic lice ( Crabs )
- Psoriasis
- Eczema
- Topical irritants
- Lichen simplex
- Lichen Planus
- Lichen sclerosus et atrophicus
- Tinea cruris
- Threadworms (pruritis ani)
What to consider:
- Is a sexually transmitted cause likely?
- If so, test for other sexually transmitted infections
- Is empirical treatment for pubic lice or scabies indicated?
- Could this be a sytemic skin disease?
History:
- Localised (where) or generalised
- Duration
- Sexual contacts
- Travel
- Presence or absence of rash
- Previous history of skin
- Disease/allergy/atopy
- Pets
- Recent medication
Examination:
Full examination of skin surface paying particular attention to:
- finger folds, skin creases (scabies)
- flexor and extensor surfaces of joints (psoriasis)
- Pubic, axillary and other body hair (pubic lice)
- Groin skin folds and natal cleft (fungal infections)
Investigation:
Skin scrapings from suspected fungal infection (onto sellotape on a glass slide or a black paper envelope) can be sent to mycology for culture/microscopy.
Management Plan
- If Diagnosis clear treat as per guidance
- Refer if diagnosis uncertain or extra risks
See also Dermatology Section on Vulval and Perianal Pruritis
