Psoriasis, atopic dermatitis and lichen sclerosus may cause chronic vulvar dermatosis Psoriasis presents as red, nonscaly, pruritic plaques, sometimes isolated to the vulva. [cmaj.ca]

A 15-year retrospective review of prepubertal girls presenting with recurrent vaginal discharge found that sexual abuse might have been involved in about 5% of cases. 2 Systemic diseases, such as eczema and psoriasis, may also present with gynecologic [mdedge.com]

An 18-year-old woman presents with severe vaginal and vulvar itching and a thick white discharge. Figure 77-1 shows the appearance of her vulva with redness and excoriations. Note the satellite lesions near the borders of the inflamed areas. [obgynkey.com]

Presentation to medical services will also be influenced by the level of parental concern. [adc.bmj.com]

If the presenting complaint is mainly dyspareunia, pelvic muscle tone may need to be assessed. [patient.info]

• Candidiasis

  Placebo in Subjects With Acute Vulvovaginal Candidiasis Recruiting NCT03734991 Phase 3 Ibrexafungerp;Placebo 17 A Study of Oral VT-1161 for the Treatment of Acute Vaginal Candidiasis (Yeast Infection) in Patients With Recurrent Vaginal Candidiasis Recruiting [malacards.org]

  Complicated VVC is characterized by recurrent (four or more episodes in 1 year) or severe VVC, non-albicans candidiasis, or the patient has uncontrolled diabetes, debilitation, or immunosuppression.1 Yeast vaginitis, yeast infection, candidiasis, moniliasis [obgynkey.com]

  Studies have shown that the prevalence of a variant MLB gene is higher in women with recurrent vulvovaginal candidiasis than in controls without candidiasis. [emedicine.medscape.com]

  The most common infectious causes of vaginitis in symptomatic women include bacterial vaginosis (22% to 50%), candidiasis (17% to 39%), and trichomoniasis (4% to 35%). [accessmedicine.mhmedical.com]

  Vulvovaginal candidiasis (VVC) is characterized by vulvovaginal itching, redness and discharge. [mdpi.com]

• Precocious Puberty

  Secondary precocious puberty due to a hormonally active ovarian tumor occurred in six patients. Idiopathic precocious puberty was found in three patients. [jnsmonline.org]

• Abdominal Pain

  This may or may not be associated with vaginal discomfort and/or abdominal pain. [accessmedicine.mhmedical.com]

  Oral azoles occasionally cause nausea, abdominal pain, and headache. Therapy with the oral azoles has been associated rarely with abnormal elevations of liver enzymes. [cdc.gov]

  Pelvic inflammatory disease (PID): Abdominal pain, cervical motion tenderness, or cervical inflammation suggests PID. [msdmanuals.com]

  Vulvovaginitis was the most common presentation (18%), followed by labial adhesions in (14%) of girls, abdominal pain in (7%) of girls, and precocious puberty in (6%). [jnsmonline.org]

• Excoriation

  Signs and symptoms include irritation and erythema of the vulva, vaginal discharge, soreness, itching, dysuria, excoriation of the area, and bleeding. It is one of the more common gynecological problems among prepubertal girls. [semanticscholar.org]

  Figure 77-1 shows the appearance of her vulva with redness and excoriations. Note the satellite lesions near the borders of the inflamed areas. [obgynkey.com]

  Occasionally steriod cream if severe excoriation/dermatitis. Bibliography Laufer MR and Emans SJ (2014) Vulvovaginal complaints in the prepubertal child. UpToDate. Accessed at www.uptodate.com Joishy M et al. [pch.health.wa.gov.au]

  Physical examination often reveals atrophy, redness, excoriations, and fissures in the vulvovaginal and perianal areas. Determining the cause is key to successful treatment. [mdedge.com]

  Signs include vulvar edema, fissures, excoriations, and thick curdy vaginal discharge. [cdc.gov]

• Skin Disease

  Irritation of the genital area due to detergents, harsh soaps, chemicals such as chlorine, bubble baths, poor hygiene practices or tight clothing Infections, with bacteria or yeast Pinworm Contact irritants Skin diseases such as eczema A foreign body [cincinnatichildrens.org]

  A personal or family history of skin disease (eg, atopy, psoriasis, eczema) or autoimmune disease (associated with lichen sclerosus) may be significant. Enquiry should be made about general health and any stress factors. [patient.info]

  Systemic illness Upper respiratory tract infections, gastrointestinal infections, and systemic diseases with skin manifestations such as measles or chicken pox. [jnsmonline.org]

• Blister

  Symptoms of vaginitis include: Itching Irritation Burning Redness Swelling Dryness Rash, blisters or bumps You may also notice: Discomfort when you urinate Pain during sex Light bleeding (spotting) Discharge and odor Abnormal discharge is one of the most [webmd.com]

• Strabismus

  J Pediatr Ophthalmol Strabismus 1998;35:159-161 Fischer GO: Vulvar disease in pre-pubertal girls. Australasian J Dermatol 2001;42:225-236 Stapleton KM, O’Loughlin E, Relic JP: Transient zinc deficiency in a breast-fed premature infant. [karger.com]

• Vaginal Bleeding

  You notice vaginal bleeding. Your child has pain or burning when urinating, and is urinating more often. You have other concerns or questions. Symptoms return. [childrensmn.org]

  vaginal discharge/vaginal bleeding was the most common symptom (49%). [jnsmonline.org]

  Vaginitis may result in vaginal soreness, itching, discharge, malodour, fissuring and bleeding. It may hurt to pass urine ( dysuria ). [dermnetnz.org]

  Vaginal foreign bodies cause an intense inflammation, resulting in vaginal bleeding and foul smelling, blood stained vaginal discharge. These cases were not included in the study. [adc.bmj.com]

  Exclusion criteria were the presence of vaginal bleeding, pregnancy, intercourse in the last 24 hours and the use of antibiotic or immunosuppressive drugs in the last month. [oatext.com]

• Estrogen Decreased

  Some treatments (eg, oophorectomy, pelvic radiation, certain chemotherapy drugs) also result in loss of estrogen. Decreased estrogen predisposes to inflammatory (particularly atrophic) vaginitis. [msdmanuals.com]

• Chlamydia Trachomatis

  trachomatis or a combination of multiple organisms. 1 Vaginitis is a spectrum of diseases causing vulvovaginal symptoms such as burning, irritation, and itching, with or without an abnormal discharge. [accessmedicine.mhmedical.com]

  Detection and differentiation of Chlamydia trachomatis, Chlamydia psittaci, and Chlamydia pneumoniae by DNA amplification. [ncbi.nlm.nih.gov]

  trachomatis, HPV, Herpes simplex must be referred to Child Protection Unit for further assessment. [pch.health.wa.gov.au]

  Discovery of Chlamydia trachomatis, N. gonorrhea, Trichomonas, and Herpes simplex should raise the suspicion of sexual abuse. Some of these may be transmitted from the mother, other family members, and caretakers by non-sexual means. [pedclerk.bsd.uchicago.edu]

  Pediatr Infect Dis J 1988;7:3 Centers for Disease Control and Prevention: Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections 2002. [karger.com]

• Neisseria Gonorrhoeae

  Pediatr Infect Dis J 1988;7:1 Whittington WL, Rice RJ, Biddle JW, et al: Incorrect identification of Neisseria gonorrhoeae from infants and children. [karger.com]

  Vaginal discharge can be secondary to a wide variety of pathologies, including vaginitis due to bacterial vaginosis, candidiasis, or trichomoniasis, as well as cervicitis, salpingitis, or pelvic inflammatory disease due to Neisseria gonorrhoeae or Chlamydia [accessmedicine.mhmedical.com]

  Candida Unusual (3%) in > 2 year old prepubertal girls Usually if recent antibiotic therapy, immunocompromised or wearing nappies Sexually Transmitted Infections Typically the result of sexual abuse with some exceptions All cases of Neisseria gonorrhoea [pch.health.wa.gov.au]

  No child in either group in this study 1 nor in that by Gerstner et al 10 had Gardernella vaginalis, Trichomonas hominis, urogenital mycoplasma, or Neisseria gonorrhoeae isolated in culture, and polymerase chain reaction amplification performed for Chlamydia [ncbi.nlm.nih.gov]

  Neisseria gonorrhoeae, the organism that causes gonorrhea, produces gonococcal vulvovaginitis in young girls who have sexual exposure. Gonorrhea-related vaginitis is considered a sexually transmitted illness. [indiatoday.in]

Therefore, treatment is usually reserved for women with bothersome symptoms. The treatments for bacterial vaginosis recommended in Canada in the PHAC’s guidelines on STI are presented in Table below. [ijogr.com]

It is a good idea to check with a doctor before starting boric acid treatment. Takeaway Treatment for vulvovaginitis depends on the cause, and some cases may go away without treatment. [medicalnewstoday.com]

Treatment consists of administration of antibiotics or antifungals (depending on the pathogen). [amboss.com]

Determining the cause is key to successful treatment. [consultqd.clevelandclinic.org]

Treatment Treatment will typically involve the use of antifungal medication, which will usually take the form of an oral tablet and/or topical skin cream. Following treatment, most cases of thrush will resolve in a few days. [ada.com]

Prognosis Most cases of pruritus resolve once the correct diagnosis is made and appropriate treatment instituted. The prognosis will depend on the underlying condition causing the vulvitis. [patient.info]

Expectations (prognosis) Proper treatment of an infection is usually very effective. [indiatoday.in]

Outlook (Prognosis) Proper treatment of an infection is effective in most cases. [ufhealth.org]

Outlook (Prognosis) Proper treatment of an infection is most often very effective. Prevention Keep your genital area clean and dry when you have vaginitis. Avoid soap. Just rinse with water to clean yourself. [account.allinahealth.org]

This article reviews the etiology, pathogenesis, clinical features, diagnosis, and management of NAC vulvovaginitis. [mdpi.com]

May try topical antibiotics or low potency steroids If there is any suspicion of abuse, cultures should be obtained with the proper culture media to try to delineate a specific etiology. References Kokotos, Faye, and Henry M. Adam. Vulvovaginitis. [pedclerk.bsd.uchicago.edu]

While many theories have been proposed, the etiology of this condition remains unknown. [emedicine.medscape.com]

System(s) affected: reproductive, skin/exocrine Synonym(s): vaginitis; vulvitis Epidemiology Incidence Unknown Prevalence Most common gynecologic problem in prepubertal girls Etiology and Pathophysiology In the prepubertal child, the levels of estrogen [unboundmedicine.com]

Table 2: Etiology of prepubertal vulvovaginitis percentage of microorganism isolates Click here to view Unfortunately, we do not have studies in Saudi Arabia about prepubertal vulvovaginitis and its etiological factors. [jnsmonline.org]

Differential diagnoses of infectious vulvovaginitis Bacterial vulvovaginitis Bacterial vaginosis Epidemiology : most common vaginal infection in women (40–45% of all cases) Pathogen : Gardnerella vaginalis (a gram-variable rod) (Gram-variable) Pathogenesis [amboss.com]

The epidemiology and presentation of vulvovaginitis differ in prepubescent and adolescent girls. [pedsinreview.aappublications.org]

System(s) affected: reproductive, skin/exocrine Synonym(s): vaginitis; vulvitis Epidemiology Incidence Unknown Prevalence Most common gynecologic problem in prepubertal girls Etiology and Pathophysiology In the prepubertal child, the levels of estrogen [unboundmedicine.com]

Epidemiologic determinants of vaginal pH. Am J Obstet Gynecol. 1999;180(5):1060-6. [ Links ] 36. Nai GA, Mello ALP, Ferreira AD, Barbosa RL. [scielo.br]

Epidemiology Exact figures are not available because the term covers so many different conditions and many women self-treat and do not consult a health professional. Females of all ages are affected, from prepubertal girls to the elderly. [patient.info]

System(s) affected: reproductive, skin/exocrine Synonym(s): vaginitis; vulvitis Epidemiology Incidence Unknown Prevalence Most common gynecologic problem in prepubertal girls Etiology and Pathophysiology In the prepubertal child, the levels of estrogen [unboundmedicine.com]

Etiology and Pathophysiology Listen Most vulvovaginal Candidiasis is caused by Candida albicans (Figure 77-3).1,7 Candida glabrata now causes a significant percentage of all Candida vulvovaginal infections. [obgynkey.com]

[…] by an alkaline vaginal discharge may lead to chronic irritation and inflammation Other - Some authors have associated vulvar vestibulitis with a history of sexual abuse, elective abortions, severe marital conflicts, depression, and anxiety Neurologic pathophysiology [emedicine.medscape.com]

Pathophysiology Prepubertal girls are susceptible to vulvovaginitis due to behavioral, anatomic, and physiologic predisposing factors. [jnsmonline.org]

Prevention There are a number of practices and habits that are thought to help prevent vaginal thrush. It should be noted, however, that these practices are not medically proven to be effective and may only be useful in some cases. [ada.com]

Good hygiene is the best way to prevent non-infectious vulvovaginitis. Wearing comfortable clothing that absorbs moisture can also reduce infection. Using a condom can prevent most sexually transmitted forms of vulvovaginitis. [medicalnewstoday.com]

Removing underwear at bedtime may also help prevent vulvovaginitis. Proper cleansing is important and may help prevent irritation. This is especially true if the infection is bacterial. [healthline.com]

Prevention Use of a condom during sexual intercourse can prevent most sexually transmitted vaginal infections. [indiatoday.in]

Possible causes of pediatric vulvovaginitis include: Bacteria Irritation due to harsh soaps or chemicals Poor hygiene Tight clothing Yeast Viruses Allergic reaction Treatment and prevention of vaginitis or vulvovaginitis Once the cause of vulvovaginitis [nortonchildrens.com]