Epithelial keratin pearls are clusters of squamous cells that become trapped within their cell layer and form microscopic masses. When found in the epithelium of the female genital tract, these pearls can become irritated and erythematous, sometimes causing significant pain for those that are affected. In adult women, they have been associated with vulvodynia and sexual health complaints, and in children, have been noted in the setting of painful clitoral phimosis and/or labial adhesions. Resolution of the pain generally occurs with removal of the pearl. Removal of the pearls has largely been performed in the operating room, and is typically achieved with lysis of the surrounding clitoral and labial adhesions and removal of the pearl manually.
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