Conditions of the Vulva

Question 1

What causes Androgen Insensitivity Syndrome?

Answer 1

Genetic deficiency in Androgen Receptors

Question 2

What will be seen with Androgen Insensitivity Syndrome?

Answer 2

46XY –> external female development though (undescended testes)

Question 3

What is Labial Agglutination?

Answer 3

Labia majoras are NOT separated

Question 4

What is the treatment for Labial Agglutination?

Answer 4

Estrogen cream

– labia majoras are not separated

Question 5

What is present with Fox-Fordyce Disease and why?

Answer 5

Yellow cysts in the axilla and labia

– Due to keratin plugged apocrine glands

Question 6

Yellow cysts in the axilla and labia due to keratin plugged apocrine glands

Answer 6

Fox-Fordyce Disease

Question 7

What is the most common genital cyst?

Answer 7

Inclusion cyst

Question 8

What causes an Inclusion cyst?

Answer 8

Hair follicle is obstructed and the deep portion swells

Question 9

Describe an Inclusion cyst

Answer 9

Beneath the epidermis

– mobile, NON-tender, spherical and slow growing

Question 10

What color are Vulvar Varicosities? When are they painful?

Answer 10

BLUE

- Can enlarge and become painful with pregnancy

Question 11

Where do Urethral Caruncles arise?

Answer 11

Distal edge of urethra

Question 12

A RED outgrowth near the distal edge of the urethra

Answer 12

Urethral Caruncle

Question 13

What can cause a Urethral Caruncle?

Answer 13

Prolapse or eversion of urethral epithelium

– red outgrowth near the distal edge of the urethra

Question 14

What causes Vulvar Vestibulitis?

Answer 14

Infection of multiple minor vestibular glands near the posterior vaginal opening

Question 15

Infection of multiple minor vestibular glands near the posterior vaginal opening

Answer 15

Vulvar Vestibulitis

Question 16

What are the symptoms/presentation of Vulvar Vestibulitis?

Answer 16

EXTREMELY tender small red dots and pain with sex

Question 17

EXTREMELY tender small red dots and possibly pain with sex is likely?

Answer 17

Vulvar Vestibulitis

– infection of minor vestibular glands

Question 18

Where do Sebaceous cysts usually arise?

Answer 18

Small masses on inner surface of labia

Question 19

What type of material is contained within a Sebaceous Cyst?

Answer 19

Cheesy material

– small masses on inner surface of labia

Question 20

What is the most common benign solid tumor of the vulva?

Answer 20

Fibroma

Question 21

What is the most common benign solid tumor of the vulva?

Answer 21

Fibroma

Question 22

What commonly causes Vulvar Hematomas?

Answer 22

Straddle injury

Sexual assault, etc.

Question 23

What is the recommended treatment for Vulvar Hematomas?

Answer 23

Close observation with possible surgical exploration

Question 24

What causes Atrophic Vaginitis?

Answer 24

Loss of estrogen

Question 25

What does the external genitalia look like with Atrophic Vaginitis?

Answer 25

ATROPHY - Decreased labia size - Loss of vaginal rugae - Vaginal introitus constriction

Question 26

3 external genitalia findings with Atrophic Vaginitis?

Answer 26

- Decreased labia size - Loss of vaginal rugae - Vaginal introitus constriction

Question 27

What is another name for Squamous Cell Hyperplasia of the Vulva?

Answer 27

Lichen Simplex Chronicus

Question 28

What causes Lichen Simplex Chronicus (squamous cell hyperplasia)?

Answer 28

Chronic itching/rubbing

Question 29

What are the histo changes that will be present with Lichen Simplex Chronicus?

Answer 29

- Thickened epithelium - Hyperkeratosis - Elongated rete ridges

Question 30

How does Lichen Simplex Chronicus look on observation?

Answer 30

Thickened red/white skin

Question 31

Thickened epithelium, hyperkeratosis and elongated rete ridges

Answer 31

Lichen Simplex Chronicus

Question 32

What are the histo changes with Lichen Sclerosis?

Answer 32

- Thin epithelium - Inflammatory cells - LOSS of rete ridges

Question 33

Thin epithelium and loss of rete ridges

Answer 33

Lichen Sclerosis

Question 34

What is present in the superficial dermis that is unique to Lichen Sclerosis?

Answer 34

Hyaline zone

Question 35

How does Lichen Sclerosis look?

Answer 35

Thin white skin with a crinkled tissue paper appearance

Question 36

Thin white skin with crinkled tissue paper appearance

Answer 36

Lichen Sclerosis

Question 37

What is the treatment for Lichen Sclerosis?

Answer 37

Clobetasol

Question 38

What are some possible complications of Lichen Sclerosis?

Answer 38

Loss of labia Introitus constriction Inverted/trapped clitoris

Question 39

Lichen Planus

Answer 39

Purplish erosive papules

Question 40

Vulvar Vaginal Gingival Syndrome

Answer 40

Lichen Planus of vulva, vagina and mouth | -- purple erosive papules

Question 41

What are the symptoms of Lichen Planus?

Answer 41

Vulva burning and insertional pain

Question 42

Contact Dermatitis

Answer 42

Specific skin irritant causes erythema, edema and ulceration

Question 43

What is the most common vulvovaginal tumor?

Answer 43

Bartholin's cyst

Question 44

How does Bartholin's cyst present?

Answer 44

Unilateral mass -- asymptomatic

Question 45

Bartholin's gland can also have an abscess. What is the cause and symptom?

Answer 45

Blockage of purulent material | -- PAIN

Question 46

What are 2 possible treatments for a Bartholin's gland abscess?

Answer 46

- Word catheterization for 4-6 weeks | - Marsupialization

Question 47

What is Marsupialization and when is it used?

Answer 47

Used for Bartholin's gland abscess treatment | = Creates new ductal opening by everting and suturing cyst wall

Question 48

What is Marsupialization?

Answer 48

Creating a new ductal opening by everting and suturing cyst wall -- Seen with Bartholin gland abscess treatment