Vulvar Signs and Symptoms in Prepubertal Girls: Recognition, Management, and When to Refer to Dermatology

Vulvar complaints are among the most frequent reasons for pediatric gynecology consultations. Vulvar dermatoses in prepubertal girls encompass a range of inflammatory, infectious, and irritant conditions that may be misdiagnosed, undertreated, or mistaken for signs of abuse. This review proposes a symptom-based framework for assessing vulvar complaints, including itching, erythema, discharge, erosions, and pain, while integrating common differential diagnoses and guidance for when to refer to dermatology. Through early recognition and management, clinicians can reduce patient distress, minimize long-term complications, and improve quality of life. In addition, a symptom-based framework is essential in assessing prepubertal genital dermatoses, as cultural beliefs and caregiver-influenced product use can shape presentation and management.