Dermatological conditions of the female genitalia

doi:10.1017/CBO9780511527036.036

35 - Dermatological conditions of the female genitalia

from Part III - Management of specific disorders

Published online by Cambridge University Press: 04 May 2010

Leith A. Banney and

Edited by

Jane MacDougall and

Leith A. Banney: Affiliation:
Department of Dermatology, Addenbrooke's Hospital, Cambridge, UK
Jane C. Sterling: Affiliation:
Reproductive Medicine Unit, University College London Hospitals, London, UK
Adam H. Balen: Affiliation:
Leeds Teaching Hospitals, University Trust
Sarah M. Creighton: Affiliation:
University College London Hospitals
Melanie C. Davies: Affiliation:
University College London
Jane MacDougall: Affiliation:
Addenbrooke's Hospital, Cambridge
Richard Stanhope: Affiliation:
Great Ormond Street Hospital

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Summary

Introduction

Disorders of the skin in the vulval area can present at any stage of life. A young child may be unable to describe changes in skin sensation and a pubertal child may not be sure what is normal and what is abnormal at a time when so many bodily changes are occurring. Vulval disease in children and adolescents may, therefore, present late and hence be diagnosed slowly. There may be misconceptions that vulval disease is a result of poor hygiene and hence a feeling of shame or embarrassment, which can result in a further delay to presentation. The causes are multiple (Table 35.1).

As in adults, the most common symptoms of vulval disease are itch and pain. In children, these may mainly be noticed by parents as a change in behaviour, for instance a reluctance to go to the toilet, as that produces pain, a wish for certain clothes that do not press on the vulval skin, or rubbing and scratching. Careful examination of the vulval skin, the vagina, where possible, the oral mucosa and the rest of the skin and appendages can give many clues to the possible diagnosis of vulval skin disease. Common and some rare causes of vulval symptoms are listed in Table 35.2 and the signs of vulval disease shown in Table 35.3.

Infections

Streptococcal infection

Definition, epidemiology and aetiology

Streptococcal infection of the vulval area is not uncommon and can present at any age, but most commonly prepubertally (Dhar et al., 1993).

Type: Chapter
Information: Paediatric and Adolescent Gynaecology
A Multidisciplinary Approach
, pp. 444 - 472

DOI: https://doi.org/10.1017/CBO9780511527036.036 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2004

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