🩺 Chapter 586 · Vulvovaginitis

Nelson Textbook of Pediatrics 22nd Edition — Most common gynecologic problem in prepubertal children (peak 4-8 years). 75% nonspecific (hygiene/irritants). Key pathogens: Group A Strep, E. coli, Shigella, pinworms. Also covers labial adhesions, lichen sclerosus, condyloma, and treatment guidelines.

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📋 30 Clinical Scenarios — Vulvovaginitis (Chapter 586)

📇 High‑Yield Review Cards

🩺 Clinical Presentations: Vulvovaginitis & Related Disorders

Select a presentation for diagnostic clues and management.

📋 Stepwise Approach: Vulvovaginitis in Children

🔑 Key Principles (Nelson Ch.586)
• Nonspecific vulvovaginitis (75%): Hygiene measures, avoid irritants, sitz baths, emollients.
• Specific pathogens: GAS (Penicillin/Amoxicillin), Shigella (TMP-SMX or Azithromycin), Pinworms (mebendazole/albendazole).
• Labial adhesions: Asymptomatic → observe. Symptomatic → topical estrogen or betamethasone.
• Lichen sclerosus: First-line ultrapotent topical steroids (clobetasol).
• STI concern: N. gonorrhoeae or C. trachomatis after neonatal period → virtually 100% indicative of sexual contact.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Chapter Summary: Vulvovaginitis