Murina Filippo, Fochesato Cecilia, Savasi Valeria Maria
Lower Genital Tract Disease Unit, V. Buzzi Hospital, University of the Study of Milan, 20124 Milan, Italy.
Department of Woman Mother and Neonate, V. Buzzi Hospital, University of the Study of Milan, 20124 Milan, Italy.
Pediatr Rep. 2024 Jul 12;16(3):558-565. doi: 10.3390/pediatric16030047.
Labial adhesions, a frequent gynecological condition in prepubertal girls, occur when the labia minora adhere along the midline. The prevailing hypothesis about their etiology suggests that labial adhesion may occur when the delicate and non-estrogenized labia minora undergo an inflammatory response, triggered by exposure to an irritant environment. Therefore, conservative treatment involves the application of topical estrogen or betamethasone cream. The role of androgens has not been considered yet in the pathophysiology or therapy of this condition. However, some studies have shown that androgen receptors are prevalent in the labia minora and vulvar vestibule.
We present the case of a 29-month-old girl with symptomatic labial adhesions. She was first ineffectively treated with topical estriol, and then she was treated with a galenic cream containing both estriol and testosterone with complete recovery and without side-effects.
Both androgens and estrogens play a significant role in maintaining the physiological trophic state of the vulva and vagina, even during childhood. Topical estriol+testosterone could be considered an alternative treatment for prepubertal labial adhesions refractory to standard topical therapy.
阴唇粘连是青春期前女孩常见的妇科疾病，发生于小阴唇沿中线粘连时。关于其病因的主流假说是，当娇嫩且未受雌激素作用的小阴唇受到刺激性环境引发炎症反应时，可能会发生阴唇粘连。因此，保守治疗包括局部应用雌激素或倍他米松乳膏。雄激素在这种疾病的病理生理学或治疗中尚未得到考虑。然而，一些研究表明雄激素受体在小阴唇和外阴前庭中普遍存在。
我们报告一例29个月大有症状阴唇粘连的女孩。她先用局部雌三醇治疗无效，然后用一种含有雌三醇和睾酮的植物药乳膏治疗，完全康复且无副作用。
雄激素和雌激素在维持外阴和阴道的生理营养状态方面都起着重要作用，即使在儿童期也是如此。局部用雌三醇+睾酮可被视为对标准局部治疗无效的青春期前阴唇粘连的替代治疗方法。
