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At least 199 records · Page 11Linked to original sources
PubMed2003

Ano-genital granulomatosis: the counterpart of oro-facial granulomatosis.

Ano-genital granulomatosis encompasses the previously recognized clinical entities of vulvitis granulomatosa, posthitis granulomatosa, and ano-perineitis granulomatosa. We report three patients with ano-genital granulomatosis. The pathological features of the disease are lymphoedema and the presence of non-caseating giant cell granulomas. These granulomas are histologically indistinguishable from those found in both Crohn's disease and sarcoidosis, therefore, patients with ano-genital granulomatosis with accompanying gastro-intestinal or pulmonary symptoms should be investigated for the presence of Crohn's disease or sarcoidosis, respectively. The value of ano-genital granulomatosis as a unifying clinicopathologic concept is to provide a label for the affliction as well as to stimulate a careful search for possibly underlying systemic disorders, thus also permitting a more specific approach to therapy.

Adult↗
PubMed1990

[CMV virus infection of the vulva and vagina].

Clinical and histopathological findings of a woman with AIDS and an ulcerated vulvovaginitis are presented. The preliminary diagnosis of a herpes vulvitis was corrected after in-situ-hybridisation of the formalin-fixed and paraffin-embedded tissue. CMV was found in macrophages and endothelial cells in the vulva and vagina. In view of the increase in the number of immuno-suppressed patients these findings should direct clinical attention to this so far unusual manifestation of a CMV-infection.

Adult↗
PubMed1991

Candida cell wall mannan in the vagina and its association with the signs and symptoms of vaginal candidosis.

Measurement of Candida cell wall polysaccharide (mannan) with an enzyme-linked immunosorbent assay (ELISA) was evaluated as an alternative to viable counting for the enumeration of yeast cell numbers in the human vagina. A statistically significant association was found between mannan levels and the number of colony forming units in vaginal washings collected from 40 women infected with Candida albicans (r = 0.81), indicating the accuracy of mannan levels in reflecting yeast cell load in vulvo-vaginal candidosis. Subsequent comparisons revealed a significant association between mannan levels and clinical signs in the vagina, so reflecting the importance of vulvitis and vaginitis as clinical markers for determining the severity of infection. No association was found between yeast load and the clinical symptoms, indicating the high degree of patient subjectivity. Estimation of mannan levels could be developed and used for the rapid laboratory investigation of chronic vulvo-vaginal candidosis.

Candida albicans↗
PubMedDate not supplied

Lower genital tract infections in women: comparison of clinical and epidemiologic findings with microbiology.

We screened 392 women attending the Laboratory of Microbiology of Toulouse Purpan Hospital for symptoms of lower genital tract infection for six microorganisms. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Candida albicans, Mycoplasma hominis, and Gardnerella vaginalis were 1%, 7.7%, 29.8%, 23.8%, and 37.5%, respectively. Trichomonas vaginalis was detected by direct examination in specimens from 3.1% of patients. Another goal of this study was to determine the relative prevalence of these microorganisms in relation to clinical and epidemiologic findings. C. trachomatis was isolated significantly more often from patients under 25 year old (P less than 0.001), from those who use oral contraceptives (P less than 0.01), from those who have a male sexual partner with symptoms of sexually transmitted disease (P less than 0.001), and from those who present signs of cervicitis (P less than 0.05). Isolation of C. albicans was significantly associated with vulvar pruritus (P less than 0.01), vulvitis (P less than 0.01), and vaginitis (P less than 0.001). G. vaginalis and M. hominis are significantly associated with bacterial vaginosis (P less than 0.001). This syndrome was diagnosed clinically in 27.2% of our study population and was highly correlated with use of an intrauterine device (P less than 0.05).

Animals↗
PubMed2005

Vulvar granuloma fissuratum: a description of fissuring of the posterior fourchette and the repair.

OBJECTIVE: To describe the characteristics of women who experience chronic fissuring of the posterior fourchette and the outcome of treatment administered. METHODS: We conducted a retrospective review of 42 women with granuloma fissuratum presenting for care between January 1, 1995, and December 31, 2003. Women underwent medical management first, and if improvement was minimal, perineoplasty was recommended. Dyspareunia and vulvar symptom scores, including itching, burning, and pain, before and after treatment were compared. RESULTS: Twenty women were managed nonoperatively, while 22 women underwent perineoplasty. The median age at diagnosis of granuloma fissuratum was 42.5 years (range 26-78). The fissure resolved in 13 of 20 women (65%) who were managed nonoperatively and in 21 of 22 women (95%) who underwent perineoplasty. Of the 11 women sexually active after perineoplasty, all had preoperative dyspareunia; it resolved in 7 (64%) women. Among the 13 women managed nonsurgically who had resolution of the fissure, 7 women were sexually active after treatment and dyspareunia resolved in 2 (29%) women. Other vulvar symptoms, such as burning, itching, pain, and discharge, showed no significant improvement after either surgical or nonsurgical treatment. CONCLUSION: Although fissuring is common with some vulvar dermatoses, such as lichen sclerosus and contact vulvitis, and often resolves with the appropriate medical management, fissuring may also occur as a primary finding and may benefit from perineoplasty.

Adult↗
PubMed2005

Urethral polyps in prepubertal girls.

PURPOSE: Urethral polyps in girls are included in the differential diagnosis of interlabial masses. Only 6 cases have been described in the English literature to date and etiology is uncertain. We present 5 more cases and review the literature. We also propose an etiology for urethral polyps in young girls and compare polyps between girls and boys as well as older females. MATERIALS AND METHODS: The medical records of prepubertal girls with urethral polyps seen at our hospital between 1980 and 2003, including operative reports and followup, were reviewed. A senior pathologist re-inspected the specimens to confirm the diagnosis. A MEDLINE search of urethral polyps was performed. RESULTS: We identified 5 girls 2 to 10 years old with urethral polyps. All girls presented with "vaginal" bleeding, 1 had recurrent urinary tract infections and vulvitis, 1 had urinary frequency, and 1 had painful voiding. The polyps were not site specific and were located in the distal, mid and proximal urethra. All polyps were excised and were found benign. Four girls were cured after 1 procedure, while in one girl the polyp reappeared. The patients were followed for 1 to 17 years and eventually became asymptomatic. CONCLUSIONS: Urethral polyps in prepubertal girls are probably benign. We suggest that the etiology of most of polyps in girls is similar to those in older females, that is a prolapsing urothelium that has evolved into a polyp.

Child↗
PubMedDate not supplied

Day-to-day follow-up after a short oral treatment of acute vaginal candidosis with itraconazole.

Seventeen patients with acute vaginal candidosis were treated for 2 days with itraconazole (200 mg daily). During 5 days after the start of the treatment, patients were daily screened for the presence of Candida (culture and microscopy) and the presence of signs and symptoms. Four days after treatment, no Candida could be detected in smears of vaginal fluid and cultures from these patients. At that time leucorrhoea, pruritus, vulvitis, and erythema were strongly reduced but had not completely disappeared.

Administration, Oral↗
PubMed2006

Non-infectious granulomatous dermatitis: a clinicopathological study.

BACKGROUND: Granulomatous dermatitis frequently presents a diagnostic challenge to dermatopathologists because an identical histologic picture is produced by several causes, and conversely, a single cause may produce varied histologic patterns. METHODS: A retrospective analysis of skin biopsies received over a period of 7 years was performed, and cases of non-infectious granulomatous dermatitis diagnosed on histopathological examination were retrieved. RESULTS: Out of a total of 586 cases of granulomatous dermatitis, 71 cases (12.11%) were categorized as non-infectious granulomatous dermatitis on the basis of clinicopathological findings. Further subcategorization was done based on morphology of granulomas as epithelioid granulomas; 15 cases of sarcoidosis, 21.1%, one case of Crohn's vulvitis, 1.4%, necrobiotic granulomas; 11 cases of granuloma annulare, 15.4%, two cases of rheumatoid nodule, 2.8%, 10 cases of foreign body granulomas, 14.0%; 32 cases of miscellaneous group, 45%. CONCLUSIONS: Morphology alone is seldom specific and cannot be used as a diagnostic tool for identification of specific diseases. Adequate clinical data and work up in combination of pathological resources can help in elucidation of specific etiology of granulomatous dermatitis. Mohan H, Bal A, Dhami GP. Non-infectious granulomatous dermatitis: a clinicopathological study.

Adolescent↗
PubMed1986

Labial adhesions in a diabetic woman.

This paper reports a 72-year-old woman with labial adhesions, who complained of difficulty in urination and terminal dribbling. The adhesions were surgically dissected with success. Diabetes mellitus in addition to poor perineal hygiene seem to have made her susceptible to the recurrent vulvitis which led to labial adhesions. This case implies the significance of detecting diabetes mellitus as a contributory factor for labial adhesions.

Aged↗
PubMedDate not supplied

A dosing study of nonoxynol-9 and genital irritation.

The objective of the study was to assess the symptoms and signs of genital irritation produced by different frequencies of nonoxynol-9 (N-9) use. Thirty-five women were randomized to each of 5 groups and used a vaginal suppository for 2 weeks. Group 1: N-9 once every other day; Group 2: N-9 once a day; Group 3: N-9 twice a day; Group 4: N-9 4 times a day; and Group 5: placebo 4 times a day. Study women were examined at admission, one week and 2 weeks with a colposcope for erythema and epithelial disruption, and were interviewed about vaginal itching and burning. The rates of reported symptoms for N-9 users were not significantly different from that of placebo users. The rate of epithelial disruption for women using N-9 every other day was essentially the same as that of women using placebo. The rates of epithelial disruption for women using N-9 1/day and 2/day were 2.5 times greater than that of placebo users. The rate of epithelial disruption for women using N-9 4/day was five times greater than that of placebo users. Genital irritation was located primarily on the vagina or cervix, and vulvitis was not a significant problem. Women who infrequently use N-9 products may not experience an increase in genital irritation. Women who choose to use N-9 frequently may experience an increase in epithelial disruption.

Adolescent↗
PubMed1982

Chlamydial infection in a family.

In a family comprising parents and two daughters, Chlamydia trachomatis (CT) was observed to be the infective agent causing urethritis in the father and conjunctivitis in the newborn. CT was probably a trigger factor in Reiter's syndrome (RS) in the mother, who suffered from arthritis, microscopic pyuria and hematuria, cervicitis and ocular manifestations. The elder daughter's mucocutaneous manifestations, probably keratodermia blennorrhagica, broke out simultaneously with chlamydial infections in the other members of the family. Later she developed joint pains, conjunctivitis and vulvitis. The elder daughter and the father are HLA-B27 negative, whereas the mother is HLA-B27 positive. With this study we would like to emphasize the importance of observing the microbial environment in the family in the etiology of rheumatic disease. Simultaneous treatment of infections in family members might benefit the clinical course of rheumatic disease.

Adult↗
PubMed1986

Vulvar disorders in the prepubertal female.

Inspection of the vulva should be a routine part of well child care. Detection of poor perineal hygiene permits the establishment of good hygiene practices, which may prevent development of vulvovaginitis. Condylomata acuminata, molluscum contagiosum, herpetic vulvitis, and vulvovaginitis secondary to Neisseria gonorrhoeae, Gardnerella vaginalis, Chlamydia trachomatis, and Trichomonas vaginalis arouse suspicion of child sexual abuse, which must be addressed. Atopic dermatitis, psoriasis, lichen planus, and lichen sclerosis et atrophicus are often chronic and early diagnosis with appropriate treatment and follow-up contributes to the acceptance of the disease by parent and child. Early detection of the rare neoplasms of the vulva is essential to improved survival.

Adolescent↗
PubMed1998

[Vulvar edema in pregnancy].

Reported is a case of massive vulvar edema complicating pregnancy probably as a result of mycotic vulvovaginitis or chemical vulvitis associated with drugs being used in the medication. Medical therapy failed to relieve the edema while the mechanical drainage showed to be an effective method of treatment.

Adult↗
PubMed1999

Vulvar disorders in adolescents.

Bacterial and fungal vulvitis, dermatitis, inflammatory dermatoses, secondary drug reactions, viral infections, and a variety of vulvar tumors can all present as primary vulvar problems in adolescents. In addition, systemic disease can present with vulvar involvement. These disorders can be extremely anxiety-provoking in adolescent females who are dealing with issues surrounding self-image, physical maturation, and sexuality. A detailed history and physical exam can provide many clues to the underlying problem, but sometimes a biopsy is necessary to establish a diagnosis. Consultations from other services, such as dermatology or infectious diseases, can be very helpful. The best approach involves a combination of empathetic reassurance, careful diagnosis, and successful treatment. In order to facilitate optimal care of adolescents with vulvar disorders, a comprehensive review of the literature is presented.

Adolescent↗
PubMed1999

An audit of diagnostic coding in genitourinary medicine clinics. Trent Region Genitourinary Medicine Audit Group.

The KC60 diagnostic code information provides an epidemiological monitor of sexually transmitted infection (STI) and a means of standardizing clinical workload in genitourinary medicine (GUM) departments. We aimed to assess the coding process and its uniformity within the Trent region by means of a confidential self-administered coding exercise with simulated case presentations. The correct coding for STIs ranged from 59.4% to 100% in different scenarios. Difficulty was identified in the coding of vulvitis and balanitis where no organism was isolated, as represented by a wide range of codes. HIV pre-test counselling without testing was coded by only 57.8% of respondents. Over 95% indicated correctly the first hepatitis B vaccine dose but 21% failed to code once only for the course. Coding practice also varied within individual sites with a 21-100% discordance. In parts diagnostic accuracy was good but there were areas of non-uniformity both within sites and cross-regionally. Regional discussions have resulted in increased training opportunities and guidelines have been developed to increase uniformity and achieve consensus in uncertain areas.

Female Urogenital Diseases↗
PubMed2000

Bilateral Krukenberg tumor of the ovary during pregnancy.

This case report concerns a 35-year-old woman suffering from gravidic cholestasis, thrombocytosis and iterative vomiting episodes who underwent an elective cesarean section at week 35 because of recent herpetic vulvitis. Large bilateral ovarian tumors were observed which were interpreted as pregnancy luteomas. Nevertheless a biopsy of the right ovary was performed. Histologic examination revealed massive luteinization of the ovarian stroma. In addition, large tumor cells were found dispersed throughout the ovary as well as in vascular spaces as either isolated or clustered signet-ring cells. In search of the primary tumor, gastroscopy revealed a gastric ulcer in the antrum. The biopsies of the ulcer margins as well as those taken at distance demonstrated signet-ring cells in the lamina propria. Bilateral salpingo-oophorectomy and total gastrectomy were performed. In spite of postoperative chemotherapy, the patient died of disease 5 months after diagnosis.

Adult↗
PubMed2002

Extramammary Paget's disease found by abnormal vulvar brush sampling.

INTRODUCTION: Doctors are usually reluctant to perform a vulvar biopsy on a patient with non-specific chronic vulvitis--especially because of the rarity of vulvar malignancy in young women--until the lesion is suspected of being malignant. Therefore, most cases of extramammary Paget's disease (EMPD) were originally misdiagnosed as chronic and recurrent vulvar lesions. Late diagnosis of invasive lesions occurring in elderly females have resulted in cases of death. CASE: A 37-year-old patient showed an extended lesion on the vulva and perineum. In addition, abnormal cells were found from a vulvar scrape smear, and a following punch biopsy was used to diagnose and determine the extension of the disease. CONCLUSION: Diagnosis and demarcation of EMPD remain difficult due to the multifocal lesions and subtle nature of the disease. Brush sampling taken from suspicious areas can be a guide for multiple biopsies to demarcate the lesion before major surgery. A brush biopsy is presented as a first-step method to detect vulvar malignancy.

Adult↗
PubMed1992

The diagnosis and treatment of bovine genital ureaplasmosis: a case study.

An outbreak of granular vulvitis and ulcerative posthitis in 24-month-old virgin Bonsmara heifers and bulls is reported. Ureaplasma was isolated locally from all the clinically infected cattle. There was marked clinical improvement within 3 d of the commencement of a 5 d course of tylosin administered intramuscularly at 10 mg kg-1. Ureaplasma could not be cultured from the external genitalia of either heifers or bulls following clinical recovery. Details of the Ureaplasma culture media are given.

Animals↗