Subject(s)
Hidradenitis Suppurativa , Sepsis , Humans , Hidradenitis Suppurativa/diagnosis , Retrospective Studies , Female , Male , Adult , Sepsis/epidemiology , Middle Aged , Symptom Flare Up , Young Adult , Hospitalization/statistics & numerical data , Patient Admission/statistics & numerical dataABSTRACT
Vulvar lichen sclerosus (VLS) is a progressive skin disease of unknown etiology. In this longitudinal case-control exploratory study, we evaluated the hormonal and microbial landscapes in 18 postmenopausal females (mean [SD] age: 64.4 [8.4] years) with VLS and controls. We reevaluated the patients with VLS after 10-14 weeks of daily topical class I steroid. We found that groin cutaneous estrone was lower in VLS than in controls (-22.33, 95% confidence interval [CI] = -36.96 to -7.70; P = .006); cutaneous progesterone was higher (5.73, 95% CI = 3.74-7.73; P < .0001). Forehead 11-deoxycortisol (-0.24, 95% CI = -0.42 to -0.06; P = .01) and testosterone (-7.22, 95% CI = -12.83 to -1.62; P = .02) were lower in disease. With treatment, cutaneous estrone (-7.88, 95% CI = -44.07 to 28.31; P = .62), progesterone (2.02, 95% CI = -2.08 to 6.11; P = .29), and 11-deoxycortisol (-0.13, 95% CI = -0.32 to 0.05; P = .15) normalized; testosterone remained suppressed (-7.41, 95% CI = -13.38 to -1.43; P = .02). 16S ribosomal RNA V1-V3 and ITS1 amplicon sequencing revealed bacterial and fungal microbiome alterations in disease. Findings suggest that cutaneous sex hormone and bacterial microbiome alterations may be associated with VLS in postmenopausal females.
Subject(s)
Microbiota , Vulvar Lichen Sclerosus , Humans , Female , Middle Aged , Aged , Case-Control Studies , Vulvar Lichen Sclerosus/microbiology , Skin/microbiology , Skin/pathology , Longitudinal Studies , Postmenopause , Progesterone/metabolism , Estrone/metabolism , Testosterone/metabolismSubject(s)
Dermatitis , Skin Diseases , Vulvar Diseases , Vulvar Neoplasms , Female , Humans , Retrospective Studies , Skin Diseases/diagnosis , Vulva , Delivery of Health Care , Vulvar Diseases/diagnosisABSTRACT
As women age, hormonal changes set the stage for a variety of vulvovaginal pathologies. Health care providers in long-term care facilities should be able to recognize and treat these conditions, especially because residents may be unable to communicate their discomfort. The objective of this article is to highlight the major vulvovaginal conditions affecting older women and provide up-to-date information on treatment for providers in long-term care facilities.