Prepubescent Vulvovaginitis
July 30, 2009
Vulvovaginitis is the irritation or inflammation of the vulva and / or vagina. The condition is frequently associated with vaginal discharge. When the condition appears in the age group of toddlers to menarche onset girls, it is termed pre-pubescent vulvovaginitis.
Clinical Presentation
The symptoms of vulvovaginitis include irritation and erythema of vulva along with offensive vaginal discharge. The discharge causes itching, excoriation of the parts. Bleeding may also occur. There may be a history of trauma or abuse or diabetes mellitus.
Causes
The list of causes for vulvovaginitis is endless. Some of the common causes may be sexual abuse, trauma, presence of foreign body, poor hygiene, candidiasis, herpes, scabies, chickenpox, measles or secondary to other infection like otitis media.
Risk Factors
Risk factors include poor hygiene, trauma, sexual abuse, diabetes mellitus or co-existing pharyngitis.
Investigations
Doing culture sensitivity for bacteria, fungi or viruses does the diagnosis for vulvovaginitis.
Special test includes exploration of vagina for foreign body, which is done in presence of long standing vaginal discharge.
Visualization of the vagina may be necessary in case of blood or foul smelling discharge is present.
Prevention
Following good hygienic practices can prevent the condition. After elimination, you must wipe off the area from front-to-back and not vice-versa. Avoiding bubble baths and using irritating products is also necessary.
The genital area must be cleaned daily with mild soap and water and then dried throughout with a soft towel. If necessary, only bland ointments must be applied for protection of the skin. Also, tight and non-occlusive clothes must be avoided.
Treatment
Hospital care becomes mandatory only in case of systemic illness. Otherwise, these cases are managed in the outpatient department only by prescribing proper medication against the infecting organism. Patient monitoring may be required in case the symptoms do not respond to the given treatment.
Prognosis
The condition usually clears with appropriate treatment if it is not due to underlying disease like psoriasis etc.
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