Gynaecology for students and practitioners . onic inflammation of the vulva is found as a sequel to theacute processes already described, more especially in gonorrhoea, inwhich constant vulval irritation may result from infective dischargefrom the cervix. Under the above heading are included certain well-marked clinical conditions, viz. eczema, leucoplakia, and kraurosis,also esthiomene and the specific ulcers. As chronic vulvitis is in- CHRONIC INFLAMMATORY CONDITIONS 341 variably accompanied by irritation in a more or less severe degree,we shall first consider this symptom. Pruritus Vulvae.
Gynaecology for students and practitioners . onic inflammation of the vulva is found as a sequel to theacute processes already described, more especially in gonorrhoea, inwhich constant vulval irritation may result from infective dischargefrom the cervix. Under the above heading are included certain well-marked clinical conditions, viz. eczema, leucoplakia, and kraurosis,also esthiomene and the specific ulcers. As chronic vulvitis is in- CHRONIC INFLAMMATORY CONDITIONS 341 variably accompanied by irritation in a more or less severe degree,we shall first consider this symptom. Pruritus Vulvae. Irritation (itching and burning) at the vulva is,of course, a symptom, not a disease ; further, it may be occasionedby a variety of morbid conditions, and may be accompaniedby other symptoms besides the above. It is classed as a distinctdisease by Sanger under the name of vulvitis pruriginosa, and Veitdescribed a definite pathological condition, parakeratosis, as char-acteristic of pruritus vulvae. In parakeratosis, processes of keratinized. :^?0:?^}/?::^li^^^^^ Fig. 162. Parakeratosis of the a case of pruritus. epithelium dip down into the corium, where they are smTounded bya zone of leucocytic infiltration {see Fig. 162). This form of dermatitisis probably not a precursor of pruritus, but is more probably theresult of rubbing and scratching. Sometimes in cases of intense itching no local morbid conditioncan be discovered. In most instances the irritation leads to frictionand scratching of the affected parts, which result in changes in thelocal appearances which may obscure the original affection. The areasmost frequently involved correspond to the clitoris and nymphse ;in severe cases the greater labia, the whole of the ostium vaginae,the perineal body, the anus, and the post-anal region all may beaffected. It may be with in children, adults, or old women. 342 GYNECOLOGY In cases of slight severity, the irritation is felt chiefly or solely atnight after retiri
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