Conditions of the Vulva and Vagina Flashcards
Examples of ambiguous genitalia presentations
Bifed Clitoris
Clitoromegaly
Cloaca
Labiascrotal fold fusion
In Female Pseudohermaphroditism, what are the most obvious presentations?
Masculinization of a female fetus presenting with clitoromegaly, hypospadiac urethra, malposititioned vagina.
Internal organs normal
What is the most common cause of male pseudohermaphroditism?
Genetic Mosaicism- Can result in AIS
Androgen Insensitivity Syndrome
Results from deficiency/inactivity of androgen receptors.
46XY genetic male, phenotypic female
X-linked recessive
Testes are undescended and need to be removed due to risk of malignancy
In True hermaphroditism, what genitalia are present?
Both male and female internal/external
List the congenital anomalies of the vulva
Pseudohermaphroditism
Androgen Insensitivity Syndrome
Hermaphroditism
List the Benign conditions of the Vulva
Labial Agglutination Fox-Fordyce Disease Inclusion Cysts Vulvar Varicosities Lentigo and Nevi Urethral Caruncles Vulvar Vestibulitis Sebacious Cysts Fibromas/Lipomas Hidradenoma Syringoma Neurofibroma Angioma
What is the treatment for Labial Agglutination?
Estrogen Cream and massage to separate the majora
What disease results from keratin-plugged inflammation of apocrine glands in the axilla, major and minora that results in a yellow raised cyst?
Fox-Fordyce Disease
How would you describe an inclusion cyst?
sub epidermal, mobile, nontender, spherical cyst that typically doesn’t require treatment
MOST COMMON genital cyst
What are vulvar varicosities
Enlarged, distended veins that can become painful around the vulva
Urethral Caruncles develop from damage to what?
Urethral Epithelium.
Appears as a small fleshy red outgrowth at the distal edge of the urethra due to either prolapse of epithelium (children) or eversion of epithelium (post-menopausal females)
A woman suffering from severe dyspareunia with 1-4mm erythematous dots that are extremely tender is due to which glands becoming infected?
Minor Vestibular Glands (Vulvar Vestibulitis)
Where do sebaceous cysts usually present?
inner surface of labia minora/majora
Pussy Pimple
What is the most common benign solid tumor of the vulva?
Fibromas
What benign pathology arises from a lesion in the sweat gland of the vulva?
Hidradenoma
“Sweating needs hydration”
Syringoma
Eccrine gland tumor
How do angiomas present?
2-3 mm red lesions in 40’s and 50’s
Traumatic Lesions of the Vulva
Hematomas
Circumcision
Obstetric trauma
Atrophic Vaginitis results in what presentation?
Labial regression
Loss of Rugae
Vaginal orifice constriction
Lichen Simplex Chronicus results in thickening/thinning of epithelium?
thickening due to itch/scratch cycle
Ddx: Psoriasis
A menopausal woman complains of pruritus, pain with sex, and burning. Exam reveals vulvar thinning with a parchment like appearance. What is the diagnosis?
Lichen Sclerosis
Lichen Planus
6 P’s: Purple, Pruiritic, Polygonal, Papules, Planar, Plaques
In psoriasis of the vulva, are the characteristic silver scales always present?
Not always, so may just appear erythematous
