Painful blisters on vulva

For female friends, the vagina is the most precious part of a female body. At the same time, many diseases may occur in the vagina, most of which are related to personal hygiene habits. Although some minor diseases do not have much impact on the human body, they can always bring some minor troubles to daily life. Vulvar blisters are a common gynecological disease. The symptoms of this disease are small blisters, which are often accompanied by stinging pain. What should we do when faced with this disease?

Vaginitis, or inflammation of the vagina, is a group of conditions that cause vulvovaginal symptoms such as itching, burning, irritation, and abnormal discharge. The vagina of a normal healthy woman has a natural defense function against the invasion of pathogens due to the characteristics of its anatomical tissue. For example, the closure of the vaginal opening, the close contact of the anterior and posterior walls of the vagina, the proliferation of vaginal epithelial cells and the keratinization of surface cells under the influence of estrogen, and the balance of vaginal acidity and alkalinity inhibit the reproduction of alkaline-adapted pathogens. The cervical mucus is alkaline. When the natural defense function of the vagina is destroyed, pathogens can easily invade and cause vaginal inflammation.

Under normal circumstances, aerobic bacteria and anaerobic bacteria live in the vagina, forming normal vaginal flora. If the ecological balance between the vagina and the bacterial flora is disrupted for any reason, conditional pathogens may also form. Common clinical diseases include: bacterial vaginosis (accounting for 22% to 50% of symptomatic women), candidal vaginitis (17% to 39%), Trichomonas vaginitis (4% to 35%), senile vaginitis, and vaginitis in young women.

Causes

1. Bacterial vaginosis

In a normal vagina, lactobacilli that produce hydrogen peroxide are dominant. Bacterial vaginosis is an endogenous mixed infection caused by a decrease in Lactobacillus and an increase in Gardnerella and anaerobic bacteria in the vagina.

2. Candidal vaginitis

(1) 80% to 90% of pathogens are Candida albicans, which grow easily in an acidic environment and are diphasic (yeast phase and hyphae phase).

(2) The patient's vaginal pH is 4.0-4.7, usually <4.5.

(3) Conditionally pathogenic bacteria (yeast phase → mycelium phase).

(4) Common causes: pregnancy, diabetes, and large-scale use of immunosuppressants and broad-spectrum antibiotics.

(5) Other contributing factors: gastrointestinal Candida, wearing tight synthetic underwear, and obesity.

3. Trichomonas vaginitis

(1) Trichomonas vaginalis grows best in a humid environment with a temperature of 25℃ to 40℃ and a pH of 5.2 to 6.6.

(2) The vaginal pH changes before and after menstruation, becoming close to neutral after menstruation, making it easier for Trichomonas to reproduce.

(3) The vaginal pH of patients is generally between 5.0 and 6.5, and most of them are > 6.0.

(4) Parasitic on the vagina, urethra or paraurethral glands, bladder, renal pelvis, male foreskin folds, urethra, and prostate.

(5) Often coexists with other vaginitis.

4. Senile vaginitis

Postmenopausal women have declining ovarian function, lower estrogen levels, vaginal wall atrophy, thinning mucosa, increased vaginal pH, reduced local resistance, and other pathogenic bacteria may over-multiply or easily invade and cause inflammation, mainly aerobic bacteria.

5. Vaginitis in young girls

It is caused by poor development of the vulva, low estrogen levels and foreign objects in the vagina of infants and young children, which trigger infection. Common pathogens include Escherichia coli, Staphylococcus aureus, Streptococcus aureus, etc.

Clinical manifestations

1. Bacterial vaginosis

10% to 40% of patients have no clinical symptoms. Those with symptoms mainly present with increased vaginal discharge with a fishy odor, which is especially aggravated after sexual intercourse and may be accompanied by mild vulvar itching or burning sensation. Examination showed no signs of congestion or inflammation in the vaginal mucosa. The secretions were grayish white, uniform, thin, and often adhered to the vaginal wall, which could be easily wiped off.

2. Candidal vaginitis

(1) Vulvar itching, burning pain, and pain during sexual intercourse.

(2) Frequent and painful urination. The characteristic of dysuria is that urine irritates the edematous vulva and vestibule during urination, causing pain.

(3) Characteristic secretion: white, thick, and resembling curd or bean curd residue.

(4) Vulvitis presents with geographic erythema, edema, and scratches.

(5) Vaginitis may cause edema, erythema, and white membrane.

3. Trichomonas vaginitis

(1) Characteristics of increased vaginal discharge: thin, purulent, yellow-green, foamy, and smelly.

(2) Location of vulvar itching: vaginal opening and vulva.

(3) If combined with urinary tract infection: frequent urination, urgency, pain, and sometimes hematuria.

(4) Infertility: Trichomonas vaginalis can devour sperm, hinder the production of lactic acid, and affect its survival in the vagina.

(5) Examination revealed: congestion of the vaginal mucosa with scattered bleeding spots, and a large amount of "strawberry-like" leucorrhea from the posterior fornix of the cervix, which was grayish yellow, yellowish-white thin liquid, or yellowish-green purulent secretions, often in a foamy state. There are no abnormal changes in the vaginal mucosa of carriers.

4. Senile vaginitis

Increased vaginal discharge, vulvar itching, etc., are often accompanied by pain during sexual intercourse.

5. Childhood vaginitis

The main symptoms are vaginal purulent discharge and vulvar itching.