-
Zhongguo Zhen Jiu = Chinese Acupuncture... May 2011To observe the therapeutic effect and safety of perineal, crissal and progenital pruritus treated with acupuncture according to differentiation. (Clinical Trial)
Clinical Trial
OBJECTIVE
To observe the therapeutic effect and safety of perineal, crissal and progenital pruritus treated with acupuncture according to differentiation.
METHODS
Self-control method was applied in these 32 cases. Changqiang (GV 1), Huiyin (CV 1), Qugu (CV 2), Sanyinjiao (SP 6) and Ashi points etc. were punctured as main points, and adjunct points were added according to differentiation: Taichong (LR 3) and Ququan (LR 8) etc. were added for wind and heat excess of liver meridian, Xuehai (SP 10) and Quchi (LI 11) etc. were added for blood deficiency and wind dryness. Itchiness, skin lesions sign scores and therapeutic effects were observed before and after treatment.
RESULTS
The total scores of itchiness before and after treatment were 6.06 +/- 1.46 and 2.19 +/- 1.71 respectively, and the total scores of skin lesions sign were 4.38 +/- 2.21 and 1.50 +/- 1.44, indicating that the scores and the total scores of itchiness and skin lesions sign reduced obviously after treatment (P < 0.05, P < 0.01); the cured and markedly effective rate was 73.4% (11/15) for wind and heat excess of liver meridian, and 70.6% (12/17) for blood deficiency and wind dryness, presenting similar therapeutic effect (P > 0.05). Hematoma or ecchymosis appeared in 2 cases, and disappeared spontaneously after 2-3 days, without obvious adverse reaction.
CONCLUSION
Simple perineal, crissal and progenital pruritus treated with acupuncture according to differentiation is effective, safe and applicable.
Topics: Acupuncture Therapy; Adolescent; Adult; Female; Humans; Male; Middle Aged; Pruritus Ani; Pruritus Vulvae; Treatment Outcome; Young Adult
PubMed: 21692284
DOI: No ID Found -
Skin Therapy Letter Mar 2011Vulvovaginal diseases commonly are inadequately diagnosed and treated. Most are dermatologic, but can be atypical in presentation in the warm, moist genital area. There...
Vulvovaginal diseases commonly are inadequately diagnosed and treated. Most are dermatologic, but can be atypical in presentation in the warm, moist genital area. There is limited training or education for medical caregivers for these conditions. The first step is correct diagnosis, which requires time and knowledge of the normal anatomy, and careful examination. Dermatologists are invaluable for management as they recognize skin problems and can correct barrier function, control inflammation, and address itching and pain.
Topics: Adrenal Cortex Hormones; Calcineurin Inhibitors; Female; Humans; Physical Examination; Pruritus Vulvae; Skin Diseases; Vaginal Diseases; Vulvar Diseases
PubMed: 21611679
DOI: No ID Found -
Journal of Lower Genital Tract Disease Jul 2011To determine whether topical triamcinolone ointment effectively reduces patient's symptoms for the management of lichen sclerosus (LS).
OBJECTIVE
To determine whether topical triamcinolone ointment effectively reduces patient's symptoms for the management of lichen sclerosus (LS).
MATERIALS AND METHODS
A retrospective chart review of LS patients seen during 2004 to 2008 in the Saint Louis University Vulvar Clinic was conducted. Inclusion criteria were biopsy-confirmed LS and age 18 years and older. Data were collected at the initial visit and at 6 to 10 weeks, 3 months, and 6 months of follow-up. Effectiveness was assessed using symptom scores on a Likert scale. Data were analyzed using either paired t tests or nonparametric Wilcoxon signed rank tests using a p value less than.05 to denote statistical significance.
RESULTS
Of 41 women, 34 met inclusion criteria. Vulvar pruritus was the most frequently reported vulvar symptom, occurring in 32 (94.1%) of 34 women. Dyspareunia, vulvar burning, and vulvar pain were reported in 17 (54.8%) of 31, 22 (64.7%) of 34, and in 13 (38.2%) of 34 women, respectively. Statistically significant reductions in mean symptom scores between the initial and the 6- to 10-week follow-up visits were found for dyspareunia, vulvar burning, vulvar pruritus, and pain (p values < .05 to < .001) and at 3-month follow-up visits for dyspareunia, vulvar burning, and vulvar pruritus (p < .05). Complete symptom relief was reported for 8 (47.1%) of 17 women with dyspareunia, 19 (86.4%) of 22 women with vulvar burning, 23 (71.9%) of 32 women with vulvar pruritus, and 12 (92.3%) of 13 women with vulvar pain.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE
Topical triamcinolone ointment is an effective treatment for the management of LS based on the significant reduction of patient symptom scores. Inherent risks with long-term use of high-potency corticosteroids should prompt all practitioners to consider triamcinolone ointment as a safer long-term treatment for patients with LS.
Topics: Adult; Dyspareunia; Female; Genital Diseases, Female; Glucocorticoids; Humans; Lichen Sclerosus et Atrophicus; Middle Aged; Missouri; Ointments; Pruritus Vulvae; Retrospective Studies; Treatment Outcome; Triamcinolone
PubMed: 21558963
DOI: 10.1097/LGT.0b013e31820a3b6f -
Indian Journal of Dermatology,... 2011The management of women with chronic benign vulvar dermatoses has been one of the most difficult and challenging aspects of women's healthcare for a long time.
BACKGROUND
The management of women with chronic benign vulvar dermatoses has been one of the most difficult and challenging aspects of women's healthcare for a long time.
AIM
Our aim was to compare the ability to approach the specific diagnosis of nonneoplastic and noninfectious vulva diseases, between the new classification system and the old classification system.
METHODS
One hundred women with chronic vulvar pruritus were included in the study. After detailed examination of the vulva, all visible lesions were biopsied, with normal skin included. All specimens was sent for dermatopathology and examined simultaneously under a binocular microscope by two pathologists. Specific diagnosis if possible and histopathological findings were classified according to both the 1987 and 2006 International Society for the Study of Vulvar Diseases (ISSVD) classifications. The ratios that were able to be approached on the specific diagnosis, with the aid the two classification systems, were compared.
RESULTS
Specific clinical diagnosis by both pathological and after using clinicopathological correlation was possible in 69 out of 91 patients (75.8%) according to the 1987 ISSVD classification, and in 81 out of 91 patients (89.0%) according to the ISSVD 2006 classification system. The difference in the clinical diagnosis ratios between the two classification systems was statistically significant ( P < 0.05). In a subgroup of women without specific diagnosis at the time of pathological examination, clinical diagnosis was made in 28 out of 50 women (56%) after using the clinicopathological correlation according to the ISSVD 1987 classification, whereas, specific diagnosis was made in 39 out of 49 (79.6%) women after using the clinicopathological correlation according to the ISSVD 2006 classification. The difference was statistically significant in terms of the ratio of the ability to achieve a specific diagnosis (P < 0.01).
CONCLUSION
ISSVD 2006 classification of nonneoplastic and noninfectious vulvar disease is more useful than the former classification, in terms of approaching the specific diagnosis of vulvar dermatoses.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Chronic Disease; Dermatitis; Dermatology; Female; Humans; Middle Aged; Pruritus Vulvae; Societies, Medical; Terminology as Topic; Young Adult
PubMed: 21508567
DOI: 10.4103/0378-6323.79698 -
International Journal of Dermatology Feb 2011The vulvar diseases are common skin conditions, but their frequency and importance are often underestimated.
BACKGROUND
The vulvar diseases are common skin conditions, but their frequency and importance are often underestimated.
OBJECTIVES
This study is aimed to investigate the frequency and clinical patterns of vulvar diseases and the risk factors associated with these diseases in patients attending a tertiary care hospital in eastern Nepal.
METHODS
Patients with vulval symptoms or cutaneous lesions on the vulva were enrolled in the study. Laboratory investigations were carried out according to need. Equal numbers of age-matched females without vulval lesions or symptoms were selected from the outpatient department as controls.
RESULTS
Of 5521 female patients attending the Dermatology Department's outpatient clinic during the study period, 105 (1.9%) had vulval symptoms and/or lesions. The most common types of vulvar disease were vulvar dermatoses (62.85%), pruritus vulvae (36.19%) and vulvodynia (0.95%). In vulvar dermatoses, infection was the most common (33.4%) manifestation, with a predominance of vulvovaginal candidiasis. Other dermatoses included: cysts and tumors (5.6%); pigmentary changes (vitiligo) (5.6%); inflammatory dermatoses (6.6%); atrophic vaginitis (1.8%); erosive disease (0.9%); and dermatosis caused by sexual abuse (1.9%). Use of nylon undergarments, occasional detergent use for washing clothes, and an irregular menstrual history were found to be associated with vulvar diseases.
CONCLUSIONS
Our study findings indicate that the known frequency of vulvar diseases may represent only a small proportion of actual frequency. Further clinical and population-based research should be carried out with respect to the treatment, follow-up, and true prevalence of these diseases in the community.
Topics: Adolescent; Adult; Female; Humans; Incidence; Middle Aged; Nepal; Prevalence; Risk Factors; Sex Offenses; Skin Diseases; Vaginitis; Vitiligo; Vulvar Diseases; Young Adult
PubMed: 21244379
DOI: 10.1111/j.1365-4632.2010.04631.x -
Journal of Obstetrics and Gynaecology... Oct 2010
Topics: Administration, Topical; Adrenal Cortex Hormones; Female; Humans; Middle Aged; Postmenopause; Progesterone; Pruritus Vulvae; Vulva; Vulvar Lichen Sclerosus
PubMed: 21176300
DOI: 10.1016/s1701-2163(16)34676-x -
Archives of Gynecology and Obstetrics Nov 2011To investigate vaginal douching habits and associated factors among women living in rural Turkey.
PURPOSE
To investigate vaginal douching habits and associated factors among women living in rural Turkey.
METHODS
This study was performed in the gynecology department of a government hospital in a rural area of Turkey, from February to March 2010. The study included 393 women admitted to the gynecology clinic. The age, marital status, education, socioeconomic status, reason for vaginal douching, douching frequency, symptoms, and previous treatments were investigated. All of the subjects were asked about the use of, frequency, and reason for vaginal douching. Significant risk factors in the vaginal douching group and odds coefficients were found using binary logistic regression.
RESULTS
The major symptoms of the subjects were itching and vaginal discharge. Of the 393 women, 317 (80.66%) performed vaginal douching and all of them had recurrent or treatment-resistant mixed agent vulvovaginitis. The majority of the women douched for ritual cleansing or washing before prayer (n = 278; 91.6%). The majority of the cases (n = 354; 90.1%) were of lower socioeconomic and educational status. The odds ratios and 95% confidence interval (CI) of the risk variables vaginal douching frequency, cervical motion tenderness, dyspareunia, and vaginal itching were 9.39 (2.07-42.48), 7.31 (2.08-25.64), 6.52 (2.26-18.78), and 1.46 (1.22-1.74), respectively.
CONCLUSIONS
In our region, vaginal douching is a common practice among women, especially those of lower socioeconomic and educational status. Clinicians should inform patients about the risks of vaginal douching to minimize the risks associated with this behavior.
Topics: Adult; Female; Gravidity; Humans; Pruritus Vulvae; Risk Factors; Rural Health; Turkey; Vaginal Discharge; Vaginal Douching; Young Adult
PubMed: 21153831
DOI: 10.1007/s00404-010-1805-6 -
Sexual & Reproductive Healthcare :... Jan 2011The aim of this study is to determine the sensitivity, specificity and the predictive value of the BV(®) Blue Test Kit in the diagnosis of bacterial vaginosis and to...
The aim of this study is to determine the sensitivity, specificity and the predictive value of the BV(®) Blue Test Kit in the diagnosis of bacterial vaginosis and to observe the risk factors associated with bacterial vaginosis (BV) in the study population. A prospective, cross-sectional study on 151 non-pregnant women who presented or referred to HUKM with presence of vaginal discharge, abnormal vaginal odour, pruritus vulvae of lower genital tract or incidental finding of abnormal PV discharge on pelvic examination. Samples of vaginal discharge were tested for bacterial vaginosis infection using Amsel's criteria, BV(®) Blue test and Gram stain (Nugent's score). Gram stain interpretation was made blinded without knowledge of other test result. Using Gram stain's criteria as a gold standard, the sensitivity, specificity, positive and negative predictive value of BV(®) Blue test and each of Amsel's criteria were estimated. The use of vaginal douches increased the risk of BV. The risk of BV with vaginal douching was 2.8 (95% CI 1.0-7.8) compared to never users. BV(®) Blue test showed a sensitivity of 100.0%, specificity of 98.3%, positive predictive value (PPV) of 94.4% and negative predictive value (NPV) of 100.0% compared to Gram stain (Nugent's method). BV(®) Blue test had excellent agreement with Gram stain which was 98.7%. BV(®) Blue test is a simple, rapid and reliable test allowing immediate diagnosis and prompt treatment of BV in the absence of microscopy which would greatly benefit majority of women at the greatest risk of sequel of bacterial vaginosis.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Malaysia; Middle Aged; Predictive Value of Tests; Prospective Studies; Reagent Kits, Diagnostic; Risk Factors; Sensitivity and Specificity; Staining and Labeling; Vaginal Douching; Vaginosis, Bacterial
PubMed: 21147452
DOI: 10.1016/j.srhc.2010.11.002 -
Dermatology Online Journal Oct 2010A 60-year-old menopausal female presented with vulvar itching for one year. She had noticed a whitish lesion on the vulva that slowly increased in size over the year....
A 60-year-old menopausal female presented with vulvar itching for one year. She had noticed a whitish lesion on the vulva that slowly increased in size over the year. She had been unsuccessfully treated with oral fluconazole and topical clotrimazole-mometasone combinations and the plaque had gradually spread to involve the clitoris and peri-urethral area. She was neither diabetic nor hypertensive and had no other systemic complaints. Examination revealed a well-defined non-tender whitish plaque situated on her left labia minora and clitoris (Figure 1). A swab from the plaque did not grow any organism. Routine blood chemistry including a VDRL and HIV ELIZA were within normal limits. A punch biopsy from the lesion was taken and histopathology findings were as seen in (Figures 2 and 3).
Topics: Aminoquinolines; Antineoplastic Agents; Diagnosis, Differential; Female; Humans; Imiquimod; Middle Aged; Paget Disease, Extramammary; Pruritus Vulvae; Vaginal Creams, Foams, and Jellies; Vulvar Neoplasms
PubMed: 21062604
DOI: No ID Found -
Dermatologic Clinics Oct 2010Vulvar pruritus is a common and distressing condition for patients, and its presentation is often delayed and complicated by home remedies. The true prevalence cannot be... (Review)
Review
Vulvar pruritus is a common and distressing condition for patients, and its presentation is often delayed and complicated by home remedies. The true prevalence cannot be accurately estimated. Vulvar pruritus is a symptom, and an underlying cause must be sought and not assumed. This is best accomplished by obtaining a careful history of vulvar care regimens and treatments, performing a detailed physical examination, and considering a broad differential diagnosis. This article provides a practical and clinical approach to the evaluation of vulvar pruritus and then focuses specifically on one common cause, lichen simplex chronicus.
Topics: Adrenal Cortex Hormones; Anesthetics; Anti-Bacterial Agents; Antifungal Agents; Calcineurin Inhibitors; Diagnosis, Differential; Female; Humans; Hypnotics and Sedatives; Medical History Taking; Neurodermatitis; Physical Examination; Pruritus Vulvae
PubMed: 20883911
DOI: 10.1016/j.det.2010.08.004