Vulvar edema - Anogenital in
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Synopsis

Vulvar edema is swelling of the vulvar tissue due to accumulation of fluid in the interstitial space. It can be a unique entity unto itself but usually is a symptom of another condition.
The edema may be related to retention of fluid or lymphatic material. It may be associated with a wide range of physiologic and pathologic conditions, including pregnancy, infections (recurrent streptococcal infection, lymphogranuloma venereum, and vulvar filariasis), inflammatory disorders (urticaria, contact dermatitis, hidradenitis suppurativa, and Crohn disease), underlying systemic disease (nephrotic syndrome, advanced liver disease, congestive heart failure, and malignant occlusion of the local lymphatics), medications (ovarian hyperstimulation syndrome), or trauma, including in the postsurgical period. Additionally, some congenital conditions, such as Milroy disease, may manifest vulvar edema.
Patients may complain of the sudden onset of unilateral or bilateral labial swelling. Others may note the swelling has been persistent for months, has been gradually getting worse, or waxes and wanes. If infection is present, patients may complain of warmth / tenderness. If swelling is severe, patients may have difficulty with urination due to obstruction or difficulty with ambulation.
The edema may be related to retention of fluid or lymphatic material. It may be associated with a wide range of physiologic and pathologic conditions, including pregnancy, infections (recurrent streptococcal infection, lymphogranuloma venereum, and vulvar filariasis), inflammatory disorders (urticaria, contact dermatitis, hidradenitis suppurativa, and Crohn disease), underlying systemic disease (nephrotic syndrome, advanced liver disease, congestive heart failure, and malignant occlusion of the local lymphatics), medications (ovarian hyperstimulation syndrome), or trauma, including in the postsurgical period. Additionally, some congenital conditions, such as Milroy disease, may manifest vulvar edema.
Patients may complain of the sudden onset of unilateral or bilateral labial swelling. Others may note the swelling has been persistent for months, has been gradually getting worse, or waxes and wanes. If infection is present, patients may complain of warmth / tenderness. If swelling is severe, patients may have difficulty with urination due to obstruction or difficulty with ambulation.
Codes
ICD10CM:
N90.89 – Other specified noninflammatory disorders of vulva and perineum
SNOMEDCT:
36311007 – Edema of vulva
N90.89 – Other specified noninflammatory disorders of vulva and perineum
SNOMEDCT:
36311007 – Edema of vulva
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Postpartum lactation of the vulva
- Vulvar varicosities
- Labial hypertrophy
- Vulvar herpes simplex or herpes zoster – edema is seen in association with herpetiform lesions
- Trichomoniasis
- Bartholin gland abscess
- Vulvar abscess
- Skene gland abscess
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:12/10/2018
Last Updated:12/25/2018
Last Updated:12/25/2018