Final answer:
Vulvar cancer should be highly considered in the differential diagnosis for a 65-year-old obese diabetic female with chronic vaginal itching and bleeding, while also considering other causes like vaginitis related to microorganism infections such as Candida albicans.
Step-by-step explanation:
Given the symptoms of chronic vaginal itching and bleeding in a 65-year-old obese diabetic female, vulvar cancer should be considered at the top of your differential diagnosis (DDx). While urinary tract infections, diabetes complications, and menopausal symptoms may also cause vaginal symptoms, the presence of bleeding raises concern for a neoplastic process. Other potential causes such as vaginitis or a yeast infection secondary to antibiotic use may contribute to the itching but are less likely to cause significant bleeding unless there is secondary trauma from scratching. Infections caused by microorganisms, typically the yeast Candida albicans, result in vaginitis, which comprises symptoms such as itching, pain, and discharge. A visit to a healthcare provider for a thorough examination, including a pelvic exam and possibly a biopsy, is critical for a proper diagnosis and management of these symptoms.