Benign Vulval Conditions - INCOMPLETE Flashcards
What does the vulva consist of?
What type of epithelial cells is the vulva composed of?
Mons pubis, Labia majora, labia minora, clitoris, and vestibule
Keratinizing Squamous epithelium
Define Vulvodynia
Pain!!, burning, stinging sensation
A patient presents to you with a vulval condition, what symptoms are associated with vulval conditions?
Vulval itch/pruritis
Vulvodynia
Dyspareunia
Discharge/bleeding
Groin lymphadenopathy
!!!Urinary symptoms
What would you ask as part of the hx for a vulval pathology?
Onset duration…
Triggers
Change in soaps, detergents, clothing
Personal and fam hx of atopy, eczema, and autoimmune conditions
A patient presents with a vulval itch and has a family history of autoimmune conditions. She herself, has crohn’s .What is the most likely diagnosis?
How will you confirm your diagnosis?
Lichen sclerosis (25%)
Focused Hx and exam looking for:
Symptoms:
Vulval itch/pruritis
Vulvodynia (pain, stinging, burning)
Dyspareunia
Urinary sx
On exam:
1) Pale, white atrophic lesions
2) Loss of labia minora +/- midline fusion
3) Hyperkeratosis in figure-8 distribution
4) Erosions and sclerosis
!!! If still unsure -> Biopsy -> Histology
What is Lichen sclerosis
What population group is most susceptible to Lichen sclerosis?
What symptoms are associated with it?
What findings are you expecting on exam?
What is the treatment of lichen sclerosis
Autoimmune inflammatory dermatosis of the vulva common in post-menopausal women
Symptoms:
Vulval itch/pruritis
Vulvodynia (pain, stinging, burning)
Dyspareunia
Urinary sx
On exam:
1) Pale, white atrophic lesions
2) Loss of labia minora +/- midline fusion
3) Hyperkeratosis in figure-8 distribution
4) Erosions and sclerosis
FYI: diagnosis is clinical and histology is only performed if unsure
Where are bartholin glands located?
It can be a cyst or an abscess. Describe the pathophysiology of it.
What is the typical presentation of a female with bartholin abscess
Located at 5 and 7 o clock on either side of the vestibule
Duct obstruction leads to stasis => infection
Presentation:
1) Painful lump
2) Cannot sit
3) Dyspareunia (either from dryness or actual pain)
A patient presents with a lump on her vulva. She cannot sit because of how painful it is. What is your management plan
Antibiotics alone have a high recurrence rate. Only give this if the patient is asymptomatic and just has the lump
1) Antibiotics
2) Local anaesthetic
3) Incision at highest point of tension and drainage
4) Marsupialization or Word Catheter (short catheter with balloon)
What is marsupialization? (how is it performed)
What is the benefit of it?
Suturing on both ends but leaving an opening to allow for further drainage and prevent obstruction. This is associated with much lower recurrence rates
