Case report

A 6-year-old girl presented with necrosis of the left labium minus. Four days earlier, she complained of vulvar pain, and her parents observed a wide-based gait. A swollen lump at the labium minus was seen, which was mistaken for a traumatic injury. At presentation to our department, the lesion had become necrotic. Further examination showed poor genital hygiene and an encircled hair at the base of the lesion, most probably derived from the patient's own head (Fig. 1). The diagnosis of hair tourniquet syndrome of the left labium minus with resulting necrosis was made, and a conservative management was performed.

Fig. 1
figure 1

Necrosis of the labium minus due to an encircled hair at the base of the lesion

Full size image

Genital hair tourniquet syndrome in children is rare and mainly seen at an age ranging from 4 to 11 years. Generally, accidental strangulation by the patient's or caregiver's head hair is postulated, although child abuse should be suspected if convincing explanation is lacking [2]. Poor genital hygiene has also been suggested as a possible cause [3]. Involvement of penis and clitoris is most frequently reported, followed by labia minora and majora [1]. Genital hair tourniquet is a severe syndrome that requires immediate medical attention. Clinicians should be aware of this entity to prevent resulting necrosis, as was the case in our patient.