Which sign is most typical of candidal vulvovaginitis?

• A. Purulent discharge
• B. Tender lymphadenopathy
• C. Extreme vulvar irritation
• D. Firm, painless ulcer

Answer: (C)

Candida vulvovaginitis mainly presents with intense itching and vulvar irritation, often with redness and swelling of the vulvar area. The itching is usually the most prominent symptom, sometimes accompanied by burning or discomfort during urination or intercourse. Discharge, when present, tends to be thick, white, and cottage-cheese–like rather than purulent. Tender lymphadenopathy isn’t typical, and a firm, painless ulcer is not characteristic of candidal infection. So, extreme vulvar irritation from itching best fits the presentation of candidal vulvovaginitis.