Let's now talk about foreign bodies in young girls.
Vaginal discharge is a common finding in patients who come to your clinic.
The foreign body is usually a cause of this discharge
and this can occur in more than 18% of patients.
The most common foreign body is toilet tissue,
but other foreign bodies should prompt further questioning.
Often a young child cannot tell you how a foreign body got there
but if you find other foreign bodies this may increase your suspicion for abuse.
Let's now review vulvovaginitis in the pediatric GYN population.
You can have non-specific vulvovaginitis versus specific vulvovaginitis
In specific vulvovaginitis, respiratory pathogens are often a culprit.
You can also have enteric pathogens.
Yeast or candida and sexually transmitted diseases,
which would indicate sexual abuse.
Pinworms are also very common as well as foreign bodies such as toilet tissue.
Polyps and tumors should also be investigated as well as systemic illnesses,
vulvar skin disease, trauma and psychosomatic vaginal complaints
and other miscellaneous irritants.
Recall that a young girl is hypoestrogenic
and therefore her vulva is prone to irritation.
Let's now look at some picture of candidiasis in young girls.
Here in the first panel you can see that the vulva is extremely erythematous.
This is usually due to the irritation from the candida.
And the next picture you can see here the cervix.
There is a curdy white discharge, which is consistent with cervicitis from candida.
The last picture here shows condyloma acuminata.
This usually occurs in the setting of human papilloma virus.