The paediatrician and the management of common gynaecological conditions
canada goose outlet shop PLEASE NOTE:Responses are moderated before posting and publication is at the absolute discretion of BMJ, however they are not peer reviewed canada goose outlet shop
canada goose outlet canada Once published, you will not have the right to remove or edit your response. Our article aimed to cover a wide breadth of common gynaecological conditions that can affect children and unfortunately we were therefore Canada Goose online not able to go in to great detail for each condition covered. We would canadian goose jacket certainly agree on the importance of an early diagnosis buy canada goose jacket cheap for lichen sclerosus cheap Canada Goose and collaboration with a dermatologist for treatment if available. The British Association of Dermatologists guidelines for the management of lichen sclerosus was not published when Canada Goose Coats On Sale we wrote our article, we can see that this is a very valuable resource. canada goose outlet canada
canada goose outlet nyc We read with interest the review on ” (1). This is an important topic but we have concerns about incorrect canada goose store information in this paper with respect to vulval disorders. Most vulval conditions are dermatological rather than gynaecological and the Canada Goose Parka involvement of a dermatologist in the management of these children is Canada Goose Jackets vital. The breadth of paediatric vulval disease is not reflected in this paper including the concept of vulval presentation of various skin conditions (eg. psoriasis, chronic bullous dermatosis of childhood, erythema multiforme) and the need to examine the rest of the skin including the hair, nails and mucosa. canada goose outlet nyc
canada goose outlet uk canada goose outlet store canada goose There appears to be some confusion within the article, for example, a vaginal discharge is not a vulval disorder. While a discharge can lead uk canada goose to a vulvitis, the two problems of vaginitis and vulvitis should be distinguished as the investigation and management of each is very different. canada goose canada goose coats on sale outlet store
canada goose outlet online uk The commonest condition seen in children presenting with vulval symptoms is an irritant dermatitis which is not specifically mentioned in the section on vulval irritation. This is often seen in those with a background of atopy and requires emollients and a mild topical steroid application intermittently with good hygiene measures. Other important disorders such as Lipschutz ulcers and genital warts have been omitted. canada goose outlet online uk
canada goose outlet online However, our major concerns relate to the section canada goose factory sale o. canada goose outlet online
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canada goose outlet black friday We canada goose coats read with interest the review on ” (1). This is an important topic but we have concerns about incorrect information in this paper with respect to vulval disorders. Most vulval conditions are dermatological rather than gynaecological and the involvement of a dermatologist in the management of these children is vital. The breadth of paediatric vulval disease is not reflected in this paper including Canada Goose Online the concept of vulval presentation of various skin conditions (eg. psoriasis, chronic bullous dermatosis of childhood, erythema multiforme) and the need to examine the rest of the skin including the hair, nails and mucosa. canada cheap canada goose uk goose outlet black friday
canada goose jacket outlet There appears to be some confusion within the article, https://www.canadagoosestorevip.com for example, a vaginal discharge is not a vulval disorder. While a discharge can lead to a vulvitis, canada goose black friday sale the two problems of vaginitis and vulvitis should be distinguished as the investigation and management of each is very buy canada goose jacket different. canada goose jacket outlet
official canada goose outlet The commonest condition seen in children presenting with vulval symptoms is an irritant dermatitis which is not specifically mentioned in the section on vulval irritation. This is often seen in those with a background of atopy and requires emollients and a mild topical steroid application intermittently canada goose uk shop with good hygiene measures. Other important disorders such as Lipschutz ulcers and genital warts have been omitted. official canada goose outlet
canada goose outlet However, our major concerns relate to the section canada goose outlet on lichen sclerosus (LS). This is an important condition which is often under recognized or with significant delay in diagnosis. The references used are old and not original. The major symptom is itch which is not always synonymous with irritation. One of the frequent presenting symptoms of LS in children is constipation which again is not mentioned. LS should always be treated, even if asymptomatic as it is a disease that can canada goose clearance sale lead to permanent anatomical change with functional sequelae. Detailed guidelines for the management of LS have been published recently (2) and were agreed by the Royal College of Paediatrics and Child Health in the consultation process. All the evidence shows that a 3 month induction regimen of an ultra potent topical steroid is the first line treatment (3). Thereafter, the management is individualized to maintain control of symptoms and signs (4). The management outlined in this review is incorrect and gives the wrong message. It should be corrected as otherwise it will lead to undertreatment and its potential consequences. As with all vulval disorders, these children should be under the care of those experienced in the management of this condition and should receive dermatological input as part of the multi disciplinary team. canada goose outlet
goose outlet canada FM Lewis MD FRCP, St John’s Institute of Dermatology, Guy’s St Thomas’ Hospital, London goose outlet canada
canada goose outlet in usa SS Velangi FRCP Queen Elizabeth University Hospital, Birmingham canada goose outlet in usa
canada goose outlet parka SM Taibjee MB BCh BMedSci MRCPCH CCT Derm DipRCPath (Dermatopathology) Dorset County Hospital, Dorchester canada goose outlet parka.