Vulvar and perivulvar infection of bacterial pathogenesis

Vulvar and perivulvar infection of bacterial pathogenesis

Paola Salzano – Orcid

Scientific coordinator of the “Vulva Forum” Naples

paola.salzano@gmail.com


DOI: 10.53146/lriog1202115

Abstract

Why are women vulnerable to bacterial infectious disease of the vulvar and perivulvar area? What kind of medical history and physical examination must be performed to arrive at a correct diagnosis? How to make a differential diagnosis between the various vulvar infectious skin diseases? Infectious diseases of the vulvar and perivulvar area have different characteristics and symptoms depending on their nature and etiological triggering factors. Abscesses, pus-containing skin sacs, are caused by bacteria of the Staphylococcus Aureus species. Folliculitis, a type of small skin abscess that affects the hair follicle, is often triggered by improper depilatory practices. Impetigo, a superficial skin infection usually caused by S. Aureus and minus S. Pyogenes, can arise as a complication of pre-existing dermatitis. Hidradenitis, characterized by painful nodules, abscesses, sinus tracts and scars, can occur due to genetic, hormonal, infectious and even immunological factors. Abscesses, folliculitis, impetigo and hidradenitis are all diseases of bacterial origin that can affect subjects at different stages of development, including women of childbearing age, with a peak incidence around the age of 20-30. For this reason and for their tendency to also arise in the vulvar and perivulvar area, they constitute a frontier study subject between dermatology and gynecology, offering significant food for thought on the dermatological skills that the gynecologist will have to acquire for the purposes of treatment. The aim of this work is therefore to offer an overview of these diseases from a purely gynecological point of view, focusing on diagnostic methods, anamnesis and therapeutic perspectives, with the auxiliary purpose of guiding the gynecologist in identifying and removing those predisposing factors that can trigger the chronicity of infectious vulvar diseases.

Keywords: abscess; folliculitis; impetigo; hidradenitis; vulvitis; infection.

Available in LRIOG Nr.1 – 2021

e-ISSN: 1824-0283


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Bartholini’s gland cysts

Bartholini’s gland cysts

Franco Anglana – Orcid, Michela Angelucci – Orcid

Corresponding Author: Franco Anglana

franco.anglana@gmail.com


DOI: 10.53146/lriog120217

Abstract

Bartholin’s glands are symmetrical vestibular tubular glands that produce a clear, transparent fluid to lubricate the vulval vestibule. When the opening of these glands becomes obstructed, the fluid remains within the gland, causing a cyst. This condition is more frequent in nulliparous women and is rare in menopausal and postmenopausal women. The overall prevalence is 2%, and the average age of the patients is 20-29 years. If the fluid becomes infected with bacteria, the cyst develops an abscess. The most frequently isolated pathogens are Escherichia coli, Neisseria gonorrhoeae and Chlamydia trachomatis. The main symptom is a tender, painful lump near the vaginal opening associated with discomfort while walking or sitting and pain during intercourse. When taking a medical history, doctors should research triggers that might cause the duct to become obstructed (previous infections, poor hygiene, tight clothing, hair removal, oestrogen/progestin use and consequent vulvar atrophy). Bartholin’s cysts are easily diagnosed by clinical examination: no laboratory or radiographic tests are necessary. However, surgery is required to treat them. Marsupialization consists of suturing the cyst wall open to ensure the gland can drain freely, thus restoring its anatomical and functional integrity.

Keywords: cyst; abscess; bartolini gland; vulvar swelling; vulvar neoformation.


Available in LRIOG Nr.1 – 2021

e-ISSN: 1824-0283


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