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Journal of Obstetrics and Gynaecology :... Jan 2015Pruritus of the vulva is a common symptom among patients attending to outpatient clinics. In the present study, we aimed to assess pathologies causing vulval pruritus in...
Pruritus of the vulva is a common symptom among patients attending to outpatient clinics. In the present study, we aimed to assess pathologies causing vulval pruritus in the reliability of biopsy in a tertiary referral centre. A total of 137 patients undergoing vulval colposcopy because of vulval pruritus were reviewed from the hospital records retrospectively. The mean age of the patients was 47.61 ± 11.88 years and 36.5% of the patients were postmenopausal. In 101 (73.7%) of the patients, macroscopic lesions were present. In 88 (64.2%) of the patients, tolidine-positive stained areas were determined under colposcopy. In total, 68 (49.6%) of the lesions were plain, whereas 51 (37.2%) of them were depigmented. Lichen simplex chronicus, lichen sclerosis and chronic inflammation were the major pathologies associated with vulval pruritus (25.5%, n = 35; 20.4%, n = 28; 14.6%, n = 20). In conclusion, several pathologies out of vulvovaginal candidiasis may lead to vulval pruritus and clinicians should be aware of the importance of biopsy in determining the underlying pathology.
Topics: Adult; Biopsy; Female; Humans; Middle Aged; Neurodermatitis; Pruritus Vulvae; Retrospective Studies; Vulva; Vulvar Lichen Sclerosus
PubMed: 25010568
DOI: 10.3109/01443615.2014.935711 -
CMAJ : Canadian Medical Association... Jun 2014
Review
Topics: Biopsy; Chronic Disease; Cognitive Behavioral Therapy; Diagnosis, Differential; Female; Humans; Middle Aged; Photochemotherapy; Postmenopause; Pruritus Vulvae
PubMed: 24549132
DOI: 10.1503/cmaj.130665 -
European Journal of Obstetrics,... Mar 2014Chronic vulvovaginal pruritus can be refractory to standard treatment. Since opioids can induce itching and opioid receptor antagonists have been shown to suppress...
OBJECTIVE
Chronic vulvovaginal pruritus can be refractory to standard treatment. Since opioids can induce itching and opioid receptor antagonists have been shown to suppress pruritus of different etiologies, we applied this treatment to patients with vulvovaginal pruritus refractory to conventional therapies.
STUDY DESIGN
Five women between 24 and 54 years of age suffering from chronic vulvovaginal pruritus were treated with 50mg naltrexone orally once a day for 3 weeks. They documented itching episodes and possible side-effects.
RESULTS
After 1 week of treatment the number of reported itching episodes decreased significantly to almost zero in all five patients. No further episodes of pruritus reoccurred during the following 2 weeks of treatment.
CONCLUSION
Treatment with the opiate antagonist naltrexone offers an alternative treatment option for patients with chronic vulvovaginal pruritus after exclusion of gynecologic, internal, and neurological causes of these symptoms.
Topics: Adult; Female; Humans; Middle Aged; Naltrexone; Narcotic Antagonists; Pruritus Vulvae
PubMed: 24388844
DOI: 10.1016/j.ejogrb.2013.12.010 -
BMJ (Clinical Research Ed.) Aug 2013
Topics: Adult; Candidiasis, Vulvovaginal; Female; Humans; Physical Examination; Pruritus Vulvae; Referral and Consultation; Sexually Transmitted Diseases; Vaginal Discharge; Vaginosis, Bacterial
PubMed: 23943752
DOI: 10.1136/bmj.f4975 -
JAMA Jun 2013
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Biopsy; Constipation; Crohn Disease; Diagnosis, Differential; Diarrhea; Drug Therapy, Combination; Female; Granuloma; Humans; Hydrocortisone; Mesalamine; Pruritus Vulvae; Vulvar Diseases
PubMed: 23800936
DOI: 10.1001/jama.2013.7080 -
The Journal of Family Practice Feb 2013
Topics: Chronic Disease; Diagnosis, Differential; Female; Humans; Middle Aged; Neurodermatitis; Pruritus Vulvae
PubMed: 23405379
DOI: No ID Found -
Archives of Gynecology and Obstetrics Jul 2013
Topics: Adrenergic Uptake Inhibitors; Adult; Clitoris; Female; Humans; Nortriptyline; Pain; Pruritus Vulvae; Vulvodynia
PubMed: 23299543
DOI: 10.1007/s00404-013-2710-6 -
Journal of Lower Genital Tract Disease Jul 2012The study aimed to determine which self-reported vulvovaginal symptoms are most consistent with candidiasis confirmed by yeast culture and to establish guidelines to... (Comparative Study)
Comparative Study
OBJECTIVE
The study aimed to determine which self-reported vulvovaginal symptoms are most consistent with candidiasis confirmed by yeast culture and to establish guidelines to determine who can be appropriately treated by telephone triage versus office examination for women with vulvovaginal symptoms.
MATERIALS AND METHODS
A retrospective chart review of 105 patients seen in the Saint Louis University Vulvar and Vaginal Disorders Specialty Center during a 14-month period was performed after institutional review board approval. Patient's age, medication use, symptom scores on a Likert rating scale for vaginal/vulvar pain, burning, itching, dyspareunia, wet-mount results, and yeast culture results were recorded. Differences in the occurrence of vaginal/vulvar symptoms of any severity between women with positive and with negative yeast culture results were calculated using χ2 and Fisher exact tests. Differences in symptom scores of any severity were compared between women with positive and with negative yeast culture results using nonparametric Kolmogorov-Smirnov test, owing to a lack of normality of the distributions. Sensitivity of 75% or greater and specificity of 67% or greater were sought for all 9 recorded symptoms. Multiple logistic regression analysis was used to determine which symptoms and their cutoff values were significant independent predictors of a positive yeast culture result. Receiver operating characteristic curve analysis was used to determine the efficacy of individual symptoms and combinations of symptoms for predicting a positive yeast culture result. A value of p < 0.05 was used to denote statistical significance.
RESULTS
Four vulvovaginal symptoms met cutoff criteria for analysis to predict a positive yeast culture result: vaginal burning, vulvar burning, vulvar itching, and clitoral pain. Vaginal burning with a score of 6 or greater (p < 0.001) and vulvar itching with a score of 5 or greater (p < 0.05) were significant independent predictors of a positive yeast culture result. Women with both a vaginal burning score of 6 or greater and a vulvar itching score 5 or greater had a positive predictive value of 91.7% (22/24). Vaginal discharge was not shown to be predictive of candidiasis.
CONCLUSIONS
Diagnosis of candidiasis using self-reported vulvovaginal symptoms by telephone triage is difficult. Self-reported scores for vaginal burning of 6 or greater and for vulvar itching of 5 or greater are significant indicators of a positive yeast culture result. Vaginal discharge was not predictive of a diagnosis of candidiasis. A symptom chart can aid office staff in telephone triage of symptomatic women.
Topics: Antifungal Agents; Candida albicans; Candidiasis, Vulvovaginal; Chi-Square Distribution; Cohort Studies; Dyspareunia; Female; Humans; Logistic Models; Multivariate Analysis; Office Visits; Physical Examination; Pruritus Vulvae; ROC Curve; Retrospective Studies; Self Report; Sensitivity and Specificity; Severity of Illness Index; Telecommunications; Triage; Vaginal Discharge
PubMed: 22453756
DOI: 10.1097/LGT.0b013e31823f9068 -
Journal of Investigational Allergology... 2011
Topics: Adrenal Cortex Hormones; Adult; Cross Reactions; Diagnostic Errors; Drug Dosage Calculations; Drug Eruptions; Female; Humans; Hypersensitivity, Delayed; Knee; Medication Errors; Meloxicam; Pruritus Vulvae; Rheumatic Diseases; Skin Tests; Thiazines; Thiazoles
PubMed: 21905514
DOI: No ID Found -
Zhongguo Zhen Jiu = Chinese Acupuncture... Jun 2011
Topics: Acupuncture Therapy; Female; Humans; Middle Aged; Pruritus Vulvae
PubMed: 21739702
DOI: No ID Found