Gayle Fischer, FACD.
Chronic vulvitis in pre-pubertal girls
Article first published online: 25 MAR 2010
© 2010 The Author. Journal compilation © 2010 The Australasian College of Dermatologists
Australasian Journal of Dermatology
Volume 51, Issue 2, pages 118–123, May 2010
How to Cite
Fischer, G. (2010), Chronic vulvitis in pre-pubertal girls. Australasian Journal of Dermatology, 51: 118–123. doi: 10.1111/j.1440-0960.2010.00631.x
- Issue published online: 3 MAY 2010
- Article first published online: 25 MAR 2010
- Submitted 5 January 2010; accepted 4 February 2010.
Pre-pubertal girls with inflammatory chronic vulval disease excluding lichen sclerosus are often described as having ‘non-specific vulvovaginitis’. The aim of this retrospective case series was to determine the aetiology of chronic vulvovaginitis in pre-pubertal (Tanner Stage 1) girls, with particular reference to candidiasis. A chart review recorded and compared the characteristics of 38 girls and 68 post-menarchal adolescents and pre-menopausal women with chronic vulvitis. Nineteen (50%) of the pre-pubertal children had been previously diagnosed with candidiasis and 21 (55%) had been treated unsuccessfully with topical antifungal agents. Candida albicans was isolated in two (5%) of the children and 37 (54%) of the adults (P < 0.001). A positive Candida culture was causally associated with chronic vulvovaginitis in 50% of the adults but in none of the children (P < 0.001). In 28 (74%) of the children and 28 (41%) of the adults, no pathogens were isolated on microbiological testing. General skin examination of the girls revealed signs of psoriasis in 27 (71%) and atopic dermatitis in nine (24%). Symptoms were controlled with topical anti-inflammatory treatment and environmental modification, including cessation of topical antifungals. Pre-pubertal girls with chronic vulvitis are likely to have either psoriasis or atopic dermatitis. Chronic vulvovaginal candidiasis is not seen in Tanner Stage 1 girls.