Vulval lesions in children are not as common as in adults and can be mistaken for developmental abnormalities or infection such as warts. Benign lesions causing no functional issues do not need treatment.

Clitoral cysts

Cystic lesions of the clitoral hood are most commonly seen after female genital mutilation [1]. They can occur after other trauma but rarely do arise spontaneously, where they can mimic clitoromegaly [2]. Larger lesions can give functional problems, and anorgasmia is described which resolved completely after excision of the epidermal cyst [3].

Vulval naevi

Several types of naevi can affect the vulva in children. Naevus comedonicus [4], naevus lipomatosus superficialis [5,6], and linear epidermal naevi [7,8] variants are rarely found on the vulva.

The majority, however, are pigmented naevi, which can be challenging to diagnose. Genital naevi can have atypical clinical and histological features as discussed in Chapter 39

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