You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A six years old girl child presents with spotting, no secondary sexual characteristic present. Cause can be: and explain in detail?
Because there is no signs of infection or menarche, foreign body is the best answer. Hemorrhagic disease will not appear as spotting. Causes of vaginal bleeding in children: Foreign body Genital tumors Urethral prolapse Lichen sclerosus Vulvovaginitis Condyloma acuminata Trauma Precocious pubey Exogenous hormone usage Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 14. Pediatric Gynecology. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.