Search

Labial adhesions are defined as the complete or partial fusion of the pudendal cleft due to the agglutination of the labia minora in the midline. They most commonly occur between 3 months and 6 years of life. Between January 1st, 2002 and December 31st, 2015, 425 girls diagnosed with labial adhesions and seen at the Unit of Pediatric and Adolescent Gynecology of Hospital de Niños de La Plata, Argentina, were analyzed. Their average age was 2.7 years (standard deviation: 2.6 years). The most common presentation of labial adhesions was that involving more than 75% of the total length of the labia (p < 0.0000001). A total of 84.2% of patients showed no symptoms and 4% had urinary symptoms. Also, 68.4% of the girls who had a history of urinary tract infection had labial adhesions with a length of involvement of > 75%. Finally, 90.6% of cases resolved with topical estrogens; and 2.1% had adverse events., (Sociedad Argentina de Pediatría.)

Introduction: The presence of sexually transmitted infections (STIs) in patients with suspected sexual abuse is uncommon in the field of pediatrics., Objectives: To establish the prevalence of anogenital findings and their relation to the presence of STIs in girls referred for suspected child sexual abuse., Material and Methods: Retrospective study conducted between January 1st, 2003 and December 31st, 2013. Physical findings and detection of STIs in girls with suspected child sexual abuse were analyzed., Results: One thousand thirty-four patients were included. Their median age was 7.9 years old. Anogenital findings were classified as class I (normal):38.4%, class II (nonspecific):38.1%, class III (specific):19.9% and class IV (definitive):3.6%. STIs were observed in 42 patients (4.1%). A relation was established between STIs and the classification of physical findings: 10 (class II: 9; class III: 1) Neisseria gonorrhoeae, 17 (class I: 2; class II: 8; class III: 7) Chlamydia trachomatis, 15 (class I: 2; class II: 10; class III: 3) Trichomonas vaginalis. Statistically significant differences for Trichomonas vaginalis (p= 0.01) and Neisseria gonorrhoeae (p < 0.0001) were observed, with predominance of nonspecific clinical signs. Both nonspecific and specific findings were similarly observed for Chlamydia trachomatis (p= 0.03)., Conclusions: Most cases of girls with suspected child sexual abuse had normal or nonspecific anogenital findings. The prevalence of STIs in these girls is low. Trichomonas vaginalis and Neisseria gonorrhoeae were related to nonspecific findings, while both nonspecific and specific findings were observed for Chlamydia trachomatis.

Dermatological complications in Turner syndrome are infrequent but occasionally cause significant morbidity. Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous affection characterized by pruritus in the anogenital area. It is yet not clear its pathophysiology but it's linked with genetic factors and autoimmunity. This is a case report of a girl with Turner syndrome with growth hormone treatment that started with vulvar pruritus and was diagnosed as lichen sclerosus.

Introduction: Vulvovaginitis accounts for 25% of all pediatric gynecology consultations., Objective: To assess the etiology of vulvovaginitis based on age and Tanner staging of breast development., Material and Methods: Descriptive, cross-sectional study conducted between January 1st and December 31st, 2011. Patients with vulvovaginitis were assessed based on two outcome measures: age group (GI: 0 to 8.9 years old, GII: 9 to 15.9 years old, and GIII: 16 to 18 years old), and the Tanner staging of breast development (I, II-III, IV-V). Results. Two hundred and twenty-nine patients were included, 78 girls in the GI group, 134 in the GII group, and 17 in the GIII group; 81 girls were classified as TI, 36 as TII-III, and 112 as TIV-V based on Tanner staging. Shigella and Oxyuris were the most commonly found etiologic agents in younger girls. Candida albicans, other Candida species, Gardnerella and Ureaplasma urealyticum were the germs most commonly observed in older patients. Oxyuris was predominant in prepubertal girls, while Candida albicans, in postpubertal girls., Conclusions: Hormonal influence was more relevant than the patient's age in terms of vulvovaginitis etiology.