Definition: Inflammatory reaction affecting vulva.
A. Primary vulvitis.
a) Sexually transmitted diseases (STDs):
♦ Bacterial: *Gonorrhea & syphilis.
*Chancroid & granuloma inguinale.
♦ Viral: *Herpes simplex & human papilloma virus (HPV).
*LGV & moluscum contagiosum.
b) Skin diseases :
♦ Allergy: e.g. clothes, skin cleanser.
♦ Parasitic: e.g. scabies & phthirus pubis.
♦ Furunculosis: staph. infection of hair follicles.
♦ Monilia: * Candidal infection especially in diabetic patients.
* Usually associated with vaginal infection.
♦ Tinea cruris: fungal infection.
♦ Intertrigo: inflammation of skin folds especially in obese females.
c) Chronic specific infections:
♦ Parasitic: bilharisiasis & elephantiasis.
♦ Bacterial: tuberculosis & actinomycosis.
B) Secondary vulvitis.
♦ Inflammatory reaction may be in response to other condition;
a) Urinary conditions: *Urine irritation (Fistulae).
*Abnormal urine (Glucosuria & Pyuria).
b) Vaginal conditions: *Trichomonal & monilial discharge.
*Menorrhagia & polymenorrhea.
c) Rectal conditions: *Oxyrius infection in children.
*Injuries e.g. recto-vaginal fistula & anal fistula.
1) Pruritus vulvae: intense desire to scratch vulva.
2) Local manifestations of inflammation:
– Pain, tenderness, hotness,
– Scratch ulcers (infected).
– Enlarged tender inguinal lymph nodes.
A. Treatment of primary vulvitis: *Local hygiene; shaving hair, keep dry, change clothes.
*Cotton made underwear.
*Topical treatment: Antiseptic, antiallergic.
*Estrogen is added in children & postmenopausal.
B. Treatment of secondary vulvitis: * Proper management of the cause.
* Ordinary management of primary vulvitis
Special types of vulvitis:
♦ Extended Itchy condition;
– Reddish gray skin is widespread & may extend to inner thigh with.
– Severe itching may cause ulcers;
– Aggravating factors are;
– Irritation by glucosuria.
– Superimposed monilial infection.
– Local diabetic neuropathy.
♦ Proper control of DM & treatment of associated infection.
♦ Neisseria gonorrhoeae, streptococci,
♦ Staphylococci, Escherichia coli,
♦ Mixed anaerobic organisms.
♦ Pain, especially on touch.
♦ Tenderness, hotness, redness & edema.
♦ Tender swelling in the posterior 1/3 labia majora.
♦ Bartholin abscess, cyst, or sinus.
♦ Rest & antibiotics.
♦ Treatment of complications;
– Drainage of abscess.
– Marsupilization of cyst.
Vulvovaginal Infections Review Dr Muhammad El Hennawy Ob/gyn specialist Rass el barr central hospital Dumyatt
Vulvitis What is vulvitis? Vulvitis is simply an inflammation of the vulva, the soft folds of skin outside the vagina. This is not a condition but rather a symptom that results from a host of diseases, infections, injuries, allergies, and other irritants. Diagnosing and treating this condition can be frustrating because it is often difficult to determine the specific cause of the irritation. What causes vulvitis? Vulvitis may be caused by one, or more, of the following: • scented or colored toilet paper • perfumed soaps or bubble baths • shampoos and hair conditioners • laundry detergents (especially enzyme-activated “cold water” formulas) • vaginal sprays, deodorants, douches, and powders • spermicides • douches that are too strong or used too frequently • hot tub and swimming pool water • synthetic undergarments without a cotton crotch • rubbing against a bicycle seat • wearing a wet bathing suit for a long period of time • horseback riding Who is at risk for vulvitis? Any female with certain allergies, sensitivities, infections, or diseases can develop vulvitis. Girls who have not yet reached puberty and postmenopausal women sometimes develop vulvitis, possibly because of inadequate levels of estrogen. What are the symptoms of vulvitis? The following are the most common symptoms for vulvitis. However, each adolescent may experience symptoms differently. Symptoms of vulvitis may include: • redness and swelling on the labia and other parts of the vulva • excruciating itching • clear, fluid-filled blisters (present when the vulva is particularly irritated) • sore, scaly, thickened, or whitish patches (more prevalent in chronic vulvitis) on the vulva The symptoms of vulvitis may resemble other conditions or medical problems. Always consult your physician for a diagnosis.