Vulvar Discomfort in a 10-Year-Old Girl

A 10-year-old girl presented to an adolescent medicine clinic with a 1-day history of genital pain that began during a dance recital. She was found to have a 1-cm erythematous mass on the right labia with overlying crusting. Initial treatment with petroleum jelly was recommended, but she was referred to a pediatric urgent care clinic for a second opinion and subsequently to an adolescent medicine clinic for further evaluation. Her medical history included the onset of puberty but she was still premenarchal, and her psychiatric history was noncontributory.