Wounds are particularly common as a result of childbirth. They generally occur as lacerations of the posterior fourchette and may extend not only into the perineum but into the rectum. If the damage has been very severe, extensive necrosis and even gangrene may follow. Severe hemorrhage is also not uncommon, forming a hematoma within the labia. If comparatively mild infection takes place, abscesses may form.

Hyperemia may be due to acute inflammatory conditions or occur as a result of local irritation, as from the oxyuris. Is accompanied by increased exudation. Passive hyperemia may be a part of a general venous stasis or the result of some local obstruction to the outflow of blood.

Inflammation of the vulva may be the result of many conditions: uncleanliness, gonorrhea, or injuries. The parts become reddened, swollen, edematous, and are accompanied by a marked exudation that may be mucoid, serous, or purulent, or any combination of the three. Pseudo-membrane may form and gangrene also may occur. Abscesses may be due to infection or to extension.

Noma pudendi is a form of gangrene that occurs spontaneously in debilitated children; it resembles noma of the face. Is very rare.

Tuberculosis, in the form of lupus, is sometimes encountered. Occurs as irregular ulcers, with necrotic bases and elevated edges.

Syphilis, usually in the form of a chancre, occurs on the vulva. Ulcers of various forms may be present, and mucous patches are very common.

Chancroid is quite frequent; is accompanied by extensive ulceration and, at times, inguinal buboes.

Elephantiasis may involve one or both labia, and cause a tremendous increase in the size of the part.

Tumors

Fibroma and fibromyoma are occasionally found projecting from a labium or the clitoris, as polypoid tumors. Lipoma, as a polyp from the labium majus, is not uncommon. Sarcoma is rare. The caruncle is a small papillary growth projecting from the urethra, is very vascular, and extremely sensitive. Papillomata are quite common, and occur as hard, flat, or projecting masses; are present in syphilis. Cancer is rare, but may arise from the skin, the labium majus, or from the glands of Bartholin. Usually occurs as a squamous epithelioma, which commonly undergoes marked degeneration and ulceration. It extends in all directions, and secondarily affects the inguinal glands.