VULVITIS
DEFINITION
Vulvitis is irritation or inflammation of the vulva, the skin right outside the vagina.
TYPES
1.CANDIDA VULVITIS: Yeast infection of female external genitals
2.CHRONIC VULVITIS: Chronic inflammatory skin condition that affects external female genitals
ETIOLOGY
INFECTIOUS
1.Bacterial vaginos
2.Viral (genital herpes
3.Fungal (candida)
4.Parasitic
NON INFECTIOUS
1.Allergic reaction
2.Vaginal sprays
3.Toilet paper with perfume or dye
4.Injury (cycling or horseback firing)
5.Skin (Eczema or Dermatitis)
6.Vaginal atrophy during menopause
RISK FACTOR
1.Diabetes
2.Douching
3.Pregnancy
4.Hormonal changes
5.Menopause
6.Low estrogen level
PATHOPHYSIOLGY
1.Due etiological factors
2.Congenital vaginal narrowing
3.Retention of vaginal secretion
4.Overgrowth infection
5.Irritated vaginal
6.Enhanced volume of vaginal secretion
7.Natural clearing of problem
8.Recurrence
CLINICAL MANIFESTATION
1.Itching
2.Redness
3.Swelling
4.Soreness
5.Pain during sex
6.Vaginal discharge
7.Bumps or warts
8.Scaly appereance
9.Dysuria
10.Thickened or whitish patches
INVESTIGATION
1.History Taking & Physical Examination
2.Blood Test: Full Blood Count (FBC)
3.Urine Test: UFEME
4.Radiology & Imaging: X-tray, Ultrasound,CT Scan, MRI Scan
Others: Pap smear, STIs test, Pelvic Exam, pH Test
DIFFERENTIAL DIAGNOSIS
1.Vaginitis
2.Vulvovaginal candidiasis
3.Cervicitis
4.Trichomoniasis
MANANGEMENT
1.MEDICATION
SPECIFIC: Tab Metronidazole 400 mg BD 7 days, Tab Secnidazole 2g OD, Clindamycin (topical) apply at affected area BD
SYMPTOMATIC: Analgesic and Antipyretic (Tab Paracetamol 1000 mg), NSAID (Tab Ibuprofen 200-300 mg, Tab Aspirin 300-600 mg), Topical Corticosteroid cream or ointment (apply and rub gently on affected area)
2.NURSING CARE
-
1.Rest in bed according to supine or recumbent, semi flower and flower position.
- Taking and monitoring vital sign such blood pressure, pulse rate, respiration rate,
temperature and pain score for show progress toward recovery.
- Insert and monitoring intravenous normal saline drip to avoid electrolyte imbalance.
- Administration medication according to prescription such as right patient, right medication,
right dosage, right route, right time, right documentation, right refuse.
- Taking blood specimen and labeling sample for investigation purpose.
- Record tracking and saving documentation for support diagnosis and as proof of activities.
7.Avoid wear pad and pantiliner to prevent from itching and rashes.
3.HEALTH EDUCATION
-
1.Attending follow up treatment according to the time and date given by doctor.
2.Take the medication with correct dosage and timing according to doctor prescription such as 2 time per day (BD), 3 time per day (TDS), 4 time per day (QID), Immediately (Stat) and when necessary (PRN).
3.Consume a balance diet based on the food pyramid such as intake of high protein food, carbohydrate food, vegetables and fruits.
4.Encourage drinking 8 glasses of boiled water a day to prevent dehydration in the body. Avoid drinking alcohol and smoking cigarettes because it can affect the health.
5.practice a healthy and active lifestyle by doing light exercise such as jogging, walking, yoga and so on for a speedy recovery capabilities.
6.Discontinue the use of the soaps, lotions, bubble bath and other products.
8.Wash the area that affected with warm water
COMPLICATION
Urinary Tract Infection
Salphingitis
Endometritis
Premature Labour
PROGNOSIS
• Can cure: early treatment and under follow up treatment
• Cannot cure: late treatment and severe complication
REFERENCES
3.Shen L, Zhang W, Yuan Y, Zhu W, Shang A. Vaginal microecological characteristics of women in different physiological and pathological period. Front Cell Infect Microbiol. 2022;12:959793.