Vulvar tenderness is caused by these reasons

The vulva is a sensitive area. Toothache occurs because of vulvar Crohn's disease, which manifests as tissue proliferation, hypertrophy and ulcer formation; the granuloma is mainly composed of epithelial-like cells, multiple giant cells and infiltrating lymphocytes, and its structure is similar to granulomatous periangiitis.

1. Reasons

Causes of vulvar tenderness: Vulvar tenderness is caused by vulvar Crohn's disease.

The characteristic lesions of vulvar Crohn's disease are noncaseating granulomas that infiltrate the subcutaneous tissue and extend into the subcutaneous fat. It manifests as tissue proliferation, hypertrophy and ulceration. The granuloma is mainly composed of epithelial-like cells, multiple giant cells and infiltrating lymphocytes, and its structure is similar to that of granulomatous periangiitis. The pathological manifestations of granulomas are consistent with those of intestinal lesions, and typical histological features include inflammatory cell infiltration, ulceration, and abscess formation. Non-caseating granulomas can be found in 10% to 25% of lesions. 22% to 75% of patients with Crohn's disease experience associated mucocutaneous symptoms. Vaginal involvement by Crohn's disease is rare. Burgdorf et al classified extraintestinal lesions of Crohn's disease into four categories:

1. Skin granulomas include sinus tracts and fistula formation around the anorectal area.

2. Aphthous ulcers on the oral mucosa.

3. Nutritional changes such as zinc, iron and folic acid deficiency.

4. Idiopathic lesions include multilineage erythema, acquired epidermolysis bullosa, and necrotizing vasculitis. Among them, perianal skin lesions are the most common. In 25% of Crohn's disease, the first symptom is perihepatic lesions.

2. Mitigation Methods

Vulvar tenderness and treatment and prevention:

The main treatments are medical treatment and local care. If there is gastrointestinal inflammation, the gastrointestinal lesions are treated first.

1. The preferred drug is sulfasalazine (SASP) taken orally at 2 to 4 g/d. If symptoms are not relieved after 1 to 2 months of single-drug use, high-dose corticosteroids should be used in combination.

2. Metronidazole can be used as a second-line drug for SAPS or during the interval between corticosteroid treatments. It is reported that metronidazole 25 mg (kg?d) treatment for 6 months can relieve vulvar edema symptoms, but is ineffective for vulvar erythema.

3. Glucocorticoids: suitable for patients with fulminant or severe cases. Local hormone injections may be given.

4. You can consider trying immunosuppressive therapy, such as oral azathioprine, usually 1.5 mg/(kg?d) in divided doses. There are also reports that local injection of 40 mg of azathioprine has a good effect in relieving vulvar swelling and pain.

5. Consider surgical treatment if the above treatments are ineffective.