A Family Doctor's Tale - VULVITIS

DOC I HAVE VULVITIS

Vulvitis is very common in all women. They either complain of itch or pain or excessive discharge of the vulva area.Infection may due to dirty hands, poor personal hygiene, excess menstruation or due to their sexual partner.It is frequently seen in a family practice both in children and adults.The most recent case was of that of a large bartholin cyst infection who was sent to the gynecologist for surgical treatment.


Vulvitis is an acute inflammation og the vulva in females.


Vulvitis is usually caused by the following:


Infections:
1.sexually transmitted disease like gonorrhea,trichomonas and chlamydia.
2.Fungal infection such as candidiasis
3.Herpes simplex in recurrent cases
4.Pediculosis pubis or lice
5.pinworm infection in children
6.Urinary infection such as cystitis


Allergies:
1.Clothings
2.perfumes
3.powders
4.drugs


Chemical irritants:
1.vaginal douche
2.detergents used to wash underwear


Mechanical irritants:
ill fitting underwear
inadequate sexual lubrication


Postmenopausal:
Atrophic vulvovaginitis after menopausal with dryness and inflammation


Generalised disorders:
Dermatological disorders such as lichen simplex


Persons who has Acute Vulvitis has the following
Symptoms:


1.vulval irritation and itch
2.discharge from vagina
3.painful or frequency of urination
4.excoriation of the inner lining of vulva


Signs:
1.discharge can be seen in female vagina
2.redness and inflammation of the vulva


Diagnosis can usually be made by :
1.History of vulval itch associated frequency of urination, painful urination or discharge from vagina


2.Vulva shows inflammation, excoriation of lining,


3.Vulval and vaginal swab to culture for bacteria and sexually transmitted organisms and the antibiotic most appropriate for it.


4. biopsy of the suspicious vulval lesions to exclude other causes of vulval problem such as tumor


1.Approprate Antibiotics, antifungal for infections especially after urine bacterial culture
2.Antihistamine medicine for itch
3.Topical oestrogen cream for postmenopausal atrophic vulvovaginitis
4.Proper hygience after urination, sexual intercourse and bathing
5.Avoid strong soaps
6.Use of lubricants during sexual intercourse
7.Weight reduction if obese
8.Treat underlying condition such as diabetes,allergic dermatitis,other skin conditions.


Prognosis is usually good with medication.
Sexual partner may need to be treated.
Recurrence is quite common.