Fifteen-minute consultation: Vulval soreness in the prepubertal girl

Case scenario A general practitioner (GP) refers to your general paediatric outpatient clinic a 6-year old girl with an intermittently sore vulva with occasional discharge. Her mother noticed her ‘vagina’/genitalia has been slightly red, and there is intermittent minimal white discharge. Clotrimazole (Canestan), prescribed by her GP, has not made any difference. What are you going to do? In this article, we discuss the aetiology and initial assessment of vulval soreness and related symptoms in the prepubertal girl. The article does not include the differential diagnoses in the peripubertal and postpubertal adolescent cohort, thereby excluding conditions related to menstruation and pregnancy (see box 1). Box 1Anatomy of prepubertal and pubertal girls The prepubertal girl’s anatomy is different from that of the pubertal girl. During puberty, labial fat pads begin to form; pubic hair grows; the vaginal mucosa becomes thicker and less thin-walled;...
Source: Archives of Disease in Childhood - Education and Practice - Category: Pediatrics Authors: Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research