Abstract
Girls’ vulva and vagina are particularly susceptible to various clinical conditions because of their anatomy, their lack of estrogen exposure, and frequent contact with irritants. In this chapter we will analyze the girl’s anatomy and how it differs from that of the adult, the most suitable testing and examination methods in that age group, and the hygiene measures recommended to preserve vulvovaginal health. The girls’ vulva may be affected by a wide range of conditions, including congenital defects, infections, dermatosis, dermatitis, and coalescence of the labia minora. This chapter will also focus on vulvovaginitis and the most common related infections, including the clinical and therapeutic controversies on HPV, the varying degrees of dermatitis and lichen sclerosus, with all the diagnostic challenges they pose, and recommended treatments. Finally, we will focus on the coalescence of labia minora and its monitoring.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kurman RJ. Blaustein’s. Pathology of the female genital tract. 5th ed. New York: Springer; 2002.
Sanfillipo J, Muram D, Lee P, Dewhurst JC. Pediatric and adolescent gynecology. Philadelphia: WB Saunders; 2001. p. 187–9.
Yung-Weng W, Ying-Ju C. A preliminary study of bottom care effects on premature infants’ heart rate and oxygen saturation. J Nurs Res. 2004;12(2):161–8.
Barclay L. Guidelines issued for gynecologic examination for adolescents in the pediatric office setting. Medscape medical news; 2010.
Caussade A. La patología vulvar en las niñas. Vulva y vagina. Diagnóstico y tratamiento. Montevideo: Bibliomédica ediciones; 2015. p. 319–39.
Singleton AF. Vaginal discharge in children and adolescents. Evolution and management: a review. Clin Pediatr. 1980;19:799–804.
Smith SD, Fischer GD. Childhood onset vulval lichen sclerosus does not resolve at puberty: a prospective case series. Pediatr Dermatol. 2009;26:725–9.
Krapf JM. Vulvovaginitis. Emedicine. Updated: Jan 19, 2018. https://emedicine.medscape.com/article/2188931-overview. Last accessed: 15 October 2018.
Fischer GO. Vulval disease in pre-pubertal girls. Australas J Dermatol. 2001;42:225–36.
Fischer G, Rogers M. Vulvar diseases in children: a clinical audit of 130 cases. Pediatr Dermatol. 2000;17:1–6.
Fischer G, Rogers M. Paediatric vulvovaginitis. In: Proceedings of the 3rd symposium on diseases of the vulva and vagina. Melbourne: Melbourne University; 1997. p. 26–9.
Caussade A. Condilomatosis vulvar en la niña. Vulva y vagina. Diagnóstico y tratamiento. Montevideo: Bibliomédica ediciones; 2015. p. 341–46.
Antonsson A, Karanfilovska S, Lindqvist PG, Hansson BG. General acquisition of human papillomavirus infections of skin occurs in early infancy. J Clin Microbiol. 2003;41:2509–14.
Syrjanen S. Current concepts on human papillomavirus infections in children. APMIS. 2010;118:494–509.
Medeiros LR, Ethur AB, Hilgert JB, Zanini RR, Berwanger O. Bozzetti MCl, et al. vertical transmission of the human papillomavirus: a systematic quantitative review. Cad Saude Publica. 2005;21:1006–15.
Rintala MA, Grenman SE, Puranen MH, Isolauri E, Ekblad U, Kero PO, et al. Transmission of high-risk human papillomavirus (HPV) between parents and infant: a prospective study of HPV in families in Finland. J Clin Microbiol. 2005;43:376–81.
Syrjanen S. HPV infections in children. Invited review. Papillomavirus Rep. 2003;14:93–110.
Atherton DJ. The aetiology and management of irritant diaper dermatitis. J Eur Acad Dermatol Venereol. 2001;15(Suppl. 1):1–4.
Powell JJ, Wojnarowska F. Childhood vulvar lichen sclerosus: an increasingly common problem. J Am Acad Dermatol. 2001;44:803–6.
Berth-Jones J, Graham-Brown RAC, Burns DA. Lichen sclerosus et atrophicus: a review of 15 cases in young girls. Clin Exp Dermatol. 1991;16:14–7.
Meyrick Thomas RH, Ridley CM, McGibbon DH, Black MM. Anogenital lichen sclerosus in women. J R Soc Med. 1996;89:694–8.
Funaro D. Lichen sclerosus: a review and practical approach. Dermatol Ther. 2004;17:28–37.
Poindexter G, Morrell D. Anogenital pruritus: lichen sclerosus in children. Pediatr Ann. 2007;36:785–91.
Maronn ML, Esterly NB. Constipation as a feature of anogenital lichen sclerosus in children. Pediatrics. 2005;115:230–2.
Priestley BL, Bleehen SS. Lichen sclerosus et atrophicus in children misdiagnosed as sexual abuse. Br Med J. 1987;295:211.
Goodfield MJD, Jones SK, Veale DJ. The connective tissue diseases. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook’s textbook of dermatology. 7th ed. Massachusetts: Blacwell Publishing Company; 2004. p. 56.119–25.
Heymann WR. Lichen sclerosus. J Am Acad Dermatol. 2007;56:683–4.
Serrano G, Millan F, Fortea JM, Grau M, Aliaga A. Topical progesterone as a treatment of choice in genital lichen sclerosus et atrophicus in children. Pediatr Dermatol. 1993;10:201.
Torok E, Orley J, Goracz G, Daroczy J. Lichen sclerosus et atrophicus in children: clinical and pathological analysis of 33 cases. Mod Probl Paediatr. 1975;17:262–71.
Bradford J, Fischer G. Long-term management of vulval lichen sclerosus in adult women. Aust N Z J Obstet Gynecol. 2010;50(2):148–52.
Matsumoto Y, Yamamoto T, Isobe T, Kusunoki T, Tsuboi R. Successful treatment of vulvar lichen sclerosus in a child with low-concentration topical tacrolimus ointment. J Dermatol. 2007;34:114–6.
Assmann T, Becker-Wegerich P, Grewe M, Megahed M, Ruzicka T. Tacrolimus ointment for the treatment of vulvar lichen sclerosus. J Am Acad Dermatol. 2003;48:935–7.
Leung AK, Robson WL, Tay-Uyboco J. The incidence of labial fusion in children. J Paediatr Child Health. 1993;29:235–6.
Gaudens DA, Moh-Ello N, Fiogbe M, et al. Labial fusion in the paediatric surgery department of Yopougon University hospital (cote d’Ivoire): 108 cases. Sante. 2008;18(1):35–8.
Capraro VJ, Greenberg H. Adhesions of the labia minora. Obstet Gynecol. 1972;39:65–9.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Caussade, A. (2019). The Vulva During Childhood. In: Bornstein, J. (eds) Vulvar Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-61621-6_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-61621-6_8
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-61620-9
Online ISBN: 978-3-319-61621-6
eBook Packages: MedicineMedicine (R0)