How do I manage pruritus vulvae caused by a possible neoplasm?
• Refer urgently all women with an unexplained vulval lump or ulcer. • If a woman presents with vulval pruritus or pain, but no other specific features, it is reasonable to use a period of ‘treat, watch, and wait’ as a method of management. But this should include active follow-up until symptoms resolve or a diagnosis is confirmed. If symptoms persist, the referral may be urgent or non-urgent, depending on the symptoms and degree of concern about cancer. • These recommendations are based on guidance from The National Institute for Health and Clinical Excellence [NICE, 2005b].
