Vulvar disorders in childhood and adolescence

Bacterial and viral infections of the vulva and the perianal region are the most frequent genital disorders in pediatric gynecology. The typical symptoms of vulvitis are redness, itching and burning as a resu lt of poor genital hygiene, but the inflammatory reaction of the vulva can also be concomitant with respiratory infections. Recurrent inflammation leads to synechia of the labia minora, a condition, which induces urethro-vaginal reflux. This, in turn, increases the irritati on of the vulva. Itching and burning are also typical symptoms for lichenificaton of the vul va. Juvenile lichen sclerosus is characterized by a high rate of spontaneou s remission in puberty, but in childhood the lesions remain symptomatic, pr esenting cutaneous atrophy with white discoloration, fissures and edema as well as scratches with microbial superinfection. Condylomata acuminata and vulva papillomatosis in childhood are primarily i nduced by HPV 6 and 11. Recent studies have improved our understanding of t he possible transmission routes of the human papilloma virus during insemin ation, pregnancy,the post-natal period and childhood.