1. What is the difference between physiologic and pathologic leukorrhea?

A. Physiologic Leukorrhea
Physiologic leukorrhea is a normal phenomenon and not a form of
vulvovaginitis. These normal secretions are produced in response to estrogen
stimulation and thus are seen in the newborn period and return when
unopposed estrogen levels rise again during early puberty. Physiologic
leukorrhea is clear or milky, relatively thin, odorless, and (usually)
nonirritating. When dried on underwear, it may appear yellow. Girls in
puberty often complain of discharge because they are not aware that these
new, often annoying, secretions are normal. Among postpubertal women,
there is significant variation in vaginal discharge, and patients can be
reassured discharge is normal in the absence of pain, pruritus, abnormal color,
or odor. 

Examination reveals normal pubertal development, including breast

buds, pubic hair, and estrogenization of the labia and distal vaginal mucosa,
along with the typical discharge. Diagnosis is confirmed by findings on wet
preparation microscopy, which reveals estrogenized epithelial cells with no
increase in leukocytes. As a general guide, there should be no more than one
polymorphonuclear leukocyte for every vaginal epithelial cell. Neither
bimanual nor speculum examinations are necessary unless concurrent
symptoms or findings suggest other problems. Treatment consists of
reassurance and education. Some patients are more comfortable wearing
unscented pantiliners.

B. Pathologic Leukorrhea
The pathologic leucorrhea needed to be considered as vulvovaginitis-
bacterial, trichomonal, monilial, tuberculous; foreign bodies (sponges,
tampons, pessaries) in the vagina; irritating douches, infection in Skene’s and
Bartholin’s glands, endocervicitis following the trauma of labor or abortion;
some-times uterine fibroids by irritation; endometritis, pyosalpingitis
profluens or hydrops tubae profluens, and the last but by all counts the most
important, especially in women definitely past the menopause, is the
appearance, de novo, of leucorrhea (serous) or of altered leucorrhea.

Sign and symtoms of pathologic leucorrhea are:

a. Cloudy and viscous vaginal discharge
b. Yellow-ish, grey-ish, or green-ish color
c. Bad odor, fishy odor, and could be itchy
d. Lots of discharge

Reference:

1. Zitelli and Davis. 2018. Atlas of Pediatric Physical Diagnosis. 7th Edition. Elsevier,
Inc.
2. digilib.unismus.ac.id
3. Ross, Waldo J. 2017. Leucorrhea. Journal of The National Medical Association.