In patients with labial fusion, a flat plane of tissue with a dense central line of tissue is usually seen when the labia majora are retracted, while an anterior opening is usually present below the clitoris. Treatment
Treatment is not usually necessary in asymptomatic cases, since most fusions will separate naturally over time, but may be required when symptoms are present. The standard method of treatment for labial fusion is the application of topical estrogen cream onto the areas of adhesion, which is effective in 90% of patients. In severe cases where the labia minora are entirely fused, causing urinary outflow obstruction or vaginal obstruction, the labia should be separated surgically. Recurrence after treatment is common but is thought to be prevented by good hygiene practices. One study has shown that betamethasone may be more effective than estrogen cream in preventing recurrence, with fewer side effects. Epidemiology
Labial fusion is not uncommon in infants and young girls. It is most common in infants between the ages of 13 and 23 months, and has an incidence of 3.3% in this age group. It is estimated that labial fusion occurs in 1.8% of all prepubertal girls. It is rare in adult women, particularly in reproductive age, but is occasionally found in postpartum and postmenopausal women. References
External links
Labial adhesions at Medscape
The link between SzPD and being underweight may also point to the involvement of biological factors.In general, prenatal caloric malnutrition, premature birth and a low birth weight are risk factors for having a mental disorder and may contribute to the development of SzPD as well. Those who have experienced traumatic brain injury may be also at risk of developing features reflective of SzPD.Other historical researchers had hypothesized excessively perfectionist, unloving or neglectful parenting could play a role. Diagnosis
DSM-5 criteria
The Diagnostic and Statistical Manual of Mental Disorders is a widely used manual for diagnosing mental disorders. DSM-5 includes SzPD with the same criteria as in DSM-IV. In the DSM-5, SzPD is described as a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by at least four of the following:
Neither desires nor enjoys close relationships, including being part of a family. Almost always chooses solitary activities. Has little, if any, interest in having sexual experiences with another person. Takes pleasure in few, if any, activities. Lacks close friends or confidants other than first-degree relatives. Appears indifferent to the praise or criticism of others. Shows emotional coldness, detachment, or flattened affectivity.According to the DSM, those with SzPD may often be unable to, or will rarely express aggressiveness or hostility, even when provoked directly. These individuals can seem vague or drifting about their goals and their lives may appear directionless.