Question

Patient with chronic vulvar pruritus is examined and shows a *red, fiery mottled background* with *whitish hyperkeratotic areas*, but no specific raised lesion --- what is the likely diagnosis?

Answer 1

The described symptoms of chronic vulvar pruritus, red mottled background, and whitish hyperkeratotic areas without specific raised lesions likely indicate lichen simplex chronicus.

Step-by-step explanation:

The description provided of a patient with chronic vulvar pruritus, a red, fiery mottled background, and whitish hyperkeratotic areas without specific raised lesions, is suggestive of a condition known as lichen simplex chronicus (LSC) or localized scratch dermatitis.

LSC is often characterized by skin that becomes thickened (hyperkeratotic) and leathery as a result of persistent scratching or rubbing.

The redness and mottling may reflect the ongoing inflammation and irritation from this chronic behavior.

Other potential conditions with similar presentations could be considered, but the chronicity and description of hyperkeratotic areas point toward LSC as a likely diagnosis.