Pediatric vulvar cysts and abnormalities

What are the signs and symptoms of pediatric vulvar cysts and abnormalities?

In pediatric patients, common vulvar cysts and abnormalities include:

• Bartholin gland cysts - These are cysts that form from a backup of fluid if skin grows over the opening of one of the Bartholin glands on either side of the vaginal opening, or if they become infected
• Canal of nuck cyst - A painless swelling  in the vulva left over from incomplete embryonic  process
• Contact dermatitis - A skin condition caused by exposure to allergens and irritants that can produce vulvar itching, burning, and red or rash-like skin on the vulva
• Epidermal inclusion cysts - Small cysts that result from injury to the skin of the vulva
• Folliculitis - Small, red, painful bumps that occur when hair follicles become irritated and/or infected
• Mucous cysts of vestibule - Fluid-filled swellings that develop when small glands are blocked near the opening of the vagina or urethra
• Sebaceous gland cyst - Small cysts, which may enlarge and become infected, that develop when the ducts to sebaceous glands are blocked
• Inguinal hernia - Soft tissue (abdominal membrane or intestine) protruding through a weak point in the groin muscle and/or labia
• Vulvar fibroma - A benign lump made up of fibrous or connective tissue
• Vulvar hematoma - An area of swollen, bruised tissue usually caused by vulvar injury
• Vulvar lipoma - A painless, slow-growing mass made up of fatty tissue

Rare vulvar cysts and abnormalities include:

• Angiokeratoma
• Hemangioma
• Condyloma
• Myoblastoma
• Pyogenic granuloma
• Rhabdomyosarcoma
• Skene duct cyst
• Mastocytoma
• Syringoma
• Vulvar cancer

How are pediatric vulvar cysts and abnormalities treated?

• Bartholin grand cysts - For mild, non-infected Bartholin gland cysts, your daughter’s doctor may prescribe a few days of sitz baths – during which your daughter will sit in a few inches of warm water several times a day. If her cyst is large or infected, the doctor can make a small incision to drain the fluid or insert a tube that allows fluid to drain out for several weeks. Your daughter will receive antibiotics if she has an infection.
• Asymptomatic epidermal inclusion cysts - These don’t require treatment. Large, infected cysts may require drainage or excision and oral antibiotics.
• Mucous cysts of vestibule - These will usually resolve on their own.
• Vulvar fibromas - Especially if they are large, are usually surgically removed
• Vulvar lipomas - Don’t require treatment unless they are large or cause pain or distress
• Canal of nuck cysts - This can be treated surgically. Your doctor will prescribe antibiotics if your daughter’s cyst is infected.
• Sebaceous gland cysts - These usually resolve on their own but may need to be drained and/or treated with antibiotics if they become large or infected.
• Inguinal hernia - This must be repaired by surgery to prevent strangulation or incarceration, which kills the affected tissue.
• Contact dermatitis - This will usually resolve on its own once the irritant or allergen is removed. Your doctor will recommend avoiding harsh soaps and detergents.
• Folliculitis - Your daughter’s doctor may prescribe antibiotic creams or pills to clear up any infection as well as warm compresses.
• Vulvar cancers and other malignant lumps - This will be treated with a combination of surgery, chemotherapy, and/or radiation. Large hemangiomas and endometriomas – or other large, painful cysts and lumps – may require surgical removal. These are extremely rare.