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1.
Minerva Ginecol ; 70(6): 729-737, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30465412

RESUMO

BACKGROUND: The woman vaginal environment is a fragile and delicate ecosystem that is often impaired by physical and chemical agents. This condition tends to damage skin barrier causing allergic reactions that lead to chronic irritating conditions. METHODS: Clinical and in-vitro studies were performed on organic cotton pads in order to assess if their use can prevent the onset of irritant conditions. During clinical studies, the panelists' skin and mucosae state were checked through a gynecological clinical examination in order to assess tissue dryness and alterations. Moreover, each panelist answered a sensorial questionnaire at the end of the test. Data were gathered and the product acceptability of use was registered in terms of itching, irritations and burning feelings. The panelist score was calculated based on VNS Scale (0-10, where 0 is the minimum value and 10 is the maximum). RESULTS: From a careful analysis of the first part of the study, it is possible to state that the tested product (organic cotton pads) has proved to reduce the onset of irritative phenomena and slight undesired effects caused by the conventional use of synthetic pads. In-vitro tests were conducted to study possible biological processes involved during allergic and sensitizing events produced by vulvitis. In particular, a pro-sensitizing test, a skin irritation on RHE (adapted from OECD 439) and tests to assess the soothing activity were performed on cell substrates. CONCLUSIONS: Results demonstrated that organic cotton pads, in each part, are safe and do not impair any physiological activities of the tissue substrates.


Assuntos
Fibra de Algodão , Vulvite/terapia , Adulto , Linhagem Celular , Feminino , Humanos , Agricultura Orgânica , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
2.
Cas Lek Cesk ; 157(7): 354-357, 2018 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-30650979

RESUMO

Disorders of vulva and vagina are the most common problem in childhood in gynecological practice. As child is not the little adult, as young girl is not little woman. Childhood is characterized by changing hormone levels, which influenced hormone-dependent tissues. Etiology and diagnostics of this most common diseases are very often different of the same problem in adult woman. The most common diseases in childhood is synechia vulvae, inflammation of vulva and vagina called vulvovaginitis and skin disorders. It is very important to know everything about diagnostics and treatment to help young girls. Key words: vulvovaginitis, lichen sclerosus, synechia vulvae, child rest period, sexual development period, yeast infection.


Assuntos
Vaginite , Vulvite , Adolescente , Criança , Feminino , Humanos , Vaginite/diagnóstico , Vaginite/terapia , Vulvite/diagnóstico , Vulvite/terapia
4.
Mo Med ; 112(4): 301-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26455062

RESUMO

The purpose of this article is to review six important inflammatory dermatoses of the vulva and to update readers on the new advancements in treatment of these mucosal conditions. Psoriasis, lichen sclerosis, lichen simplex chronicus and lichen planus are common vulvar conditions that cause pruritis and/or pain. PIasma cell vulvitis and desquamative inflammatory vaginitis are rare and challenging to be recognized, which often remain undiagnosed.


Assuntos
Corticosteroides/uso terapêutico , Dermatopatias/tratamento farmacológico , Dermatopatias/fisiopatologia , Doenças da Vulva/tratamento farmacológico , Doenças da Vulva/fisiopatologia , Administração Tópica , Feminino , Humanos , Líquen Plano/fisiopatologia , Líquen Plano/terapia , Psoríase/fisiopatologia , Psoríase/terapia , Dermatopatias/terapia , Doenças da Vulva/terapia , Líquen Escleroso Vulvar/fisiopatologia , Líquen Escleroso Vulvar/terapia , Vulvite/fisiopatologia , Vulvite/terapia
5.
Clin Obstet Gynecol ; 58(3): 464-75, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26125955

RESUMO

Inflammatory vulvar dermatoses affect many women, but are likely underdiagnosed due to embarrassment and reluctance to visit a health care provider. Although itch and pain are common presenting symptoms, the physical examination can help distinguish between different disease entities. Because many women's health providers have minimal training in the categorization and management of dermatologic disease, definitive diagnosis and management can be difficult. Herein, strategies for diagnosing vulvar lichen sclerosus, lichen planus, contact dermatitis, lichen simplex chronicus, and psoriasis are discussed along with basic management of these diseases, which commonly involves decreasing inflammation through behavioral change, gentle skin care, topical corticosteroids, and systemic therapies.


Assuntos
Dermatopatias/diagnóstico , Doenças da Vulva/diagnóstico , Administração Cutânea , Administração Oral , Corticosteroides/uso terapêutico , Dermatite de Contato/diagnóstico , Dermatite de Contato/terapia , Feminino , Humanos , Líquen Plano/diagnóstico , Líquen Plano/terapia , Neurodermatite/diagnóstico , Neurodermatite/terapia , Psoríase/diagnóstico , Psoríase/terapia , Higiene da Pele/métodos , Dermatopatias/terapia , Doenças da Vulva/terapia , Líquen Escleroso Vulvar/diagnóstico , Líquen Escleroso Vulvar/terapia , Vulvite/diagnóstico , Vulvite/terapia
6.
J Int Assoc Provid AIDS Care ; 12(3): 159-61, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23449712

RESUMO

Vulvitis circumscripta plasmacellularis or Zoon vulvitis is a rare benign condition that affects the vulva chronically. We herein report a case of Zoon vulvitis in a 52-year-old HIV-infected patient with an uncommon ulcerovegetating lesion diagnosed by histopathologic findings. The patient was treated with clobetasol propionate ointment and oral corticosteroid. Zoon vulvitisis is a rare vulvar disorder that offers a challenging diagnose and therapy. The patient was appropriately treated and remains disease free.


Assuntos
Infecções por HIV/patologia , Plasmócitos/fisiologia , Úlcera Cutânea/patologia , Vulvite/patologia , Diagnóstico Diferencial , Feminino , Infecções por HIV/complicações , Infecções por HIV/terapia , Humanos , Pessoa de Meia-Idade , Úlcera Cutânea/etiologia , Úlcera Cutânea/terapia , Vulvite/etiologia , Vulvite/terapia
7.
Obstet Gynecol ; 120(3): 689-706, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22914482

RESUMO

Pregnancies complicated by severe sepsis and septic shock are associated with increased rates of preterm labor, fetal infection, and preterm delivery. Sepsis onset in pregnancy can be insidious, and patients may appear deceptively well before rapidly deteriorating with the development of septic shock, multiple organ dysfunction syndrome, or death. The outcome and survivability in severe sepsis and septic shock in pregnancy are improved with early detection, prompt recognition of the source of infection, and targeted therapy. This improvement can be achieved by formulating a stepwise approach that consists of early provision of time-sensitive interventions such as: aggressive hydration (20 mL/kg of normal saline over the first hour), initiation of appropriate empiric intravenous antibiotics (gentamicin, clindamycin, and penicillin) within 1 hour of diagnosis, central hemodynamic monitoring, and the involvement of infectious disease specialists and critical care specialists familiar with the physiologic changes in pregnancy. Thorough physical examination and imaging techniques or empiric exploratory laparotomy are suggested to identify the septic source. Even with appropriate antibiotic therapy, patients may continue to deteriorate unless septic foci (ie, abscess, necrotic tissue) are surgically excised. The decision for delivery in the setting of antepartum severe sepsis or septic shock can be challenging but must be based on gestational age, maternal status, and fetal status. The natural inclination is to proceed with emergent delivery for a concerning fetal status, but it is imperative to stabilize the mother first, because in doing so the fetal status will likewise improve. Aggressive [corrected] treatment of sepsis can be expected to reduce the progression to severe sepsis and septic shock and prevention strategies can include preoperative skin preparations and prophylactic antibiotic therapy as well as appropriate immunizations.


Assuntos
Complicações Infecciosas na Gravidez , Sepse , Corticosteroides/uso terapêutico , Antibacterianos/uso terapêutico , Transfusão de Sangue , Corioamnionite/diagnóstico , Corioamnionite/terapia , Endometrite/diagnóstico , Endometrite/terapia , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/terapia , Feminino , Hidratação , Humanos , Insulina/uso terapêutico , Pneumonia/diagnóstico , Pneumonia/terapia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/etiologia , Complicações Infecciosas na Gravidez/terapia , Pielonefrite/diagnóstico , Pielonefrite/terapia , Ressuscitação , Sepse/diagnóstico , Sepse/epidemiologia , Sepse/etiologia , Sepse/terapia , Choque Séptico/diagnóstico , Choque Séptico/etiologia , Choque Séptico/prevenção & controle , Choque Séptico/terapia , Estados Unidos/epidemiologia , Vulvite/diagnóstico , Vulvite/terapia
8.
G Ital Dermatol Venereol ; 146(5): 317-20, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21956267

RESUMO

AIM: Pediatric inflammatory vulvitis (PIV) is clinically characterized by itching, soreness and inflammation and can be due to both an infective process and a non-specific irritative process, especially in atopic patients. Sometimes these non-specific PIVs, that tend to be recurrent, can be overinfected, with exacerbation of the clinical features. The importance of the cleansers, emollients, and the kind of textiles that enter in direct contact all day long with the inflamed skin, is well known. The study objective is the evaluation of the safety and efficacy of the transpiring, slightly elastic knitted silk briefs, with anti-bacterial and non-irritating properties, registered as Dermasilk®, in recurrent PIV. METHODS: The study we conducted was a prospective cohort study of 12 pre-pubertal girls, aged between 2 and 10 years, affected by recurrent PIV, that used Dermasilk® briefs in association to conventional treatments. RESULTS: Dermasilk® briefs have proven to be an effective and safe adjuvant product available for use in association with conventional drugs for the treatment of recurrent PIV. CONCLUSION: Dermasilk® briefs play an important role in the management of the flares of recurrent PIV, proven by an earlier resolution of symptoms, as well as in the maintenance of the remission and in the prevention of overinfections.


Assuntos
Vestuário , Seda , Têxteis , Vulvite/terapia , Criança , Pré-Escolar , Feminino , Humanos , Projetos Piloto , Estudos Prospectivos , Recidiva
9.
J Low Genit Tract Dis ; 14(1): 56-8, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20040837

RESUMO

We report 3 cases of plasma cell vulvitis (Zoon vulvitis) over a 10-year period and their management. This series highlights 1 case that was refractory to all modalities of treatment and hence had to be managed surgically, which has only been reported once before.


Assuntos
Plasmócitos/patologia , Vulvite/diagnóstico , Vulvite/patologia , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento , Vulvite/cirurgia , Vulvite/terapia
10.
J Gynecol Obstet Biol Reprod (Paris) ; 37(5): 449-56, 2008 Sep.
Artigo em Francês | MEDLINE | ID: mdl-18614297

RESUMO

No satisfactory therapy has yet been found to relieve many chronic pelviperineal pains such as Dyspareunia, Vulvodynia, Coccygodynia and other various pelvic pains, although these can be highly disruptive in everyday life. They may be brought on by an osteo-myo-fascial disorder, often undetected despite the possibility to effectively treat, this condition using manual medicine in the gynaecologist's office. A framed clinical examination protocol as well as a therapeutic one are offered in this novel approach still rarely implemented in gynaecology. Such treatment is documented in six typical clinical cases and a global study on 86 patients with disruptive chronic pelviperineal pain, showing 71% satisfactory results following two manual medicine sessions. These very encouraging results need to be confirmed on a larger scale in order to establish an appropriate teaching protocol.


Assuntos
Terapias Complementares/métodos , Medicina Osteopática/métodos , Dor Pélvica/etiologia , Dor Pélvica/terapia , Adolescente , Adulto , Idoso , Dispareunia/terapia , Feminino , Doenças dos Genitais Femininos/terapia , Humanos , Dor Lombar/terapia , Manipulação Ortopédica/métodos , Pessoa de Meia-Idade , Dor Pélvica/diagnóstico , Estudos Retrospectivos , Região Sacrococcígea , Resultado do Tratamento , Vulvite/fisiopatologia , Vulvite/terapia
11.
Hautarzt ; 59(8): 649-52, 2008 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-17965839

RESUMO

Human seminal plasma allergy (HSPA) is a rare allergic reaction to specific protein fractions of seminal plasma, whereof PSA seems to be a relevant allergen. Predominantly Type I-immunoreactions can occur. The main symptoms are localized and generalized urticaria and sometimes anaphylactic symptoms. The diagnosis is based on history, skin tests and on the determination of specific IgE-levels for (un)fractionated seminal plasma. Here we report a patient with recurrent episodes of generalized urticaria after unprotected sexual intercourse and positive prick-test-reaction on seminal plasma.


Assuntos
Hipersensibilidade Imediata/etiologia , Sêmen/imunologia , Urticária/etiologia , Vulvite/etiologia , Adulto , Preservativos , Dessensibilização Imunológica , Diagnóstico Diferencial , Feminino , Humanos , Hipersensibilidade Imediata/diagnóstico , Hipersensibilidade Imediata/imunologia , Hipersensibilidade Imediata/terapia , Testes Intradérmicos , Urticária/diagnóstico , Urticária/imunologia , Urticária/terapia , Vulvite/diagnóstico , Vulvite/imunologia , Vulvite/terapia
12.
Clin J Pain ; 23(7): 598-604, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17710010

RESUMO

OBJECTIVE: To correlate changes in vestibular pain thresholds to general pain thresholds in a subgroup of women with provoked vestibulodynia taking part in a treatment study. METHODS: Thirty-five women with provoked vestibulodynia were randomized to 4 months' treatment with either electromyographic biofeedback (n=17) or topical lidocaine (n=18). Vestibular and general pressure pain thresholds (PPTs) were measured and the health survey Short Form-36 (SF-36) was filled out before treatment and at a 6-month follow-up. Subjective treatment outcome and bodily pain were analyzed. Thirty healthy women of the same age served as controls for general PPTs and SF-36. RESULTS: No differences in outcome measures were observed between the 2 treatments. Vestibular pain thresholds increased from median 30 g before to 70 g after treatment in the anterior vestibule (P<0.001) and from median 20 to 30 g in the posterior vestibule (P<0.001). PPTs on the leg and arm were lower in the patients as compared with controls both before and at the 6-month follow-up. Patients reporting total cure were 3/35; 25/35 were improved. The number of patients who frequently reported of other bodily pain was reduced after the treatment. The patients had lower scores for SF-36 (General Health, Vitality) before treatment, which was restored at the 6-month follow-up. DISCUSSION: Treating provoked vestibulodynia by either topical lidocaine or electromyographic biofeedback increased vestibular pain thresholds, reduced dyspareunia, and improved bodily pain. The patients showed a general hypersensitivity to pressure pain compared with controls and in this study the hypersensitivity did not seem to be affected by treating the superficial dyspareunia.


Assuntos
Hiperalgesia/diagnóstico , Hiperalgesia/terapia , Manejo da Dor , Limiar da Dor , Dor/diagnóstico , Vulvite/diagnóstico , Vulvite/terapia , Adolescente , Adulto , Feminino , Humanos , Medição da Dor , Síndrome , Resultado do Tratamento
13.
Acta Obstet Gynecol Scand ; 85(11): 1360-7, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17091418

RESUMO

BACKGROUND: To evaluate the efficacy of electromyographic biofeedback and topical lidocaine treatment for women with vulvar vestibulitis. METHODS: A prospective randomized study where 46 women with vulvar vestibulitis were randomized to receive either electromyographic biofeedback or topical lidocaine treatment for four months. Assessments with vulvar pressure pain thresholds and questionnaires regarding quality of life, psychosocial adjustments, and sexual functioning were made before treatment, after treatment, and at six- and 12-month follow-ups. Nonparametric statistical methods were used to analyze differences in outcomes. RESULTS: Nine women (9/46) dropped out during the treatment period. Both treatments showed significantly improved values for vestibular pressure pain thresholds, quality of life measurements, and sexual functioning at the 12-month follow-up. No differences were found between the two treatment groups. No severe side effects were reported. CONCLUSIONS: Four months' treatment with electromyographic biofeedback and topical lidocaine gave statistically significant improvements on vestibular pain measurements, sexual functioning, and psychosocial adjustments at the 12-month follow-up. No differences in outcome between the two treatments were observed but a larger sample may be needed to obtain significance. The treatments were well tolerated but the compliance to the electromyographic biofeedback training program was low. A combination of both treatments could potentially benefit many women with vulvar vestibulitis.


Assuntos
Anestésicos Locais/uso terapêutico , Biorretroalimentação Psicológica , Eletromiografia , Lidocaína/uso terapêutico , Vulvite/terapia , Adaptação Psicológica , Administração Tópica , Adolescente , Adulto , Dispareunia/terapia , Feminino , Humanos , Medição da Dor , Qualidade de Vida , Comportamento Sexual , Ajustamento Social
17.
Tidsskr Nor Laegeforen ; 125(8): 1026-7, 2005 Apr 21.
Artigo em Norueguês | MEDLINE | ID: mdl-15852078

RESUMO

BACKGROUND: Women with longstanding vulvar problems have difficulties finding medical care. In 2000, a first Norwegian vulvar clinic was opened at the Olafia centre for venereology in Oslo. The initiative was continued in 2003 by a multi-professional team in the dept. of gynaecology and obstetrics at Rikshospitalet University Hospital. METHODS: Medical records from the two Vulva clinics have been reviewed in retrospect. RESULTS: During the period 2000 to 2003, a total of 217 patients had 470 visits to the Olafia clinic, mean age 31.4 years. Vulvodynia was diagnosed in 52% of all patients, 30% had a genital infection, 22% a genital dermatitis or dermatosis and 21% a primary sexual problem. At the multi-professional Rikshospitalet vulva clinic, run by specialists in gynaecology and dermato-venereology, 141 patients had 206 visits in 2003, mean age 42.5 years. Vulvodynia was diagnosed in 38%, 26% had a genital skin condition, 11% primary sexual problems, 10% a genital infection, and 10% a gynaecological problem. A few patients were healthy controls. The difference in diagnostic groups is related to the age of the patients. CONCLUSION: The options for vulvar patients have improved in Oslo. Multi-professional cooperation has been achieved in our department, which serves as a national referral centre.


Assuntos
Ambulatório Hospitalar , Doenças da Vulva , Saúde da Mulher , Adolescente , Adulto , Idoso , Dispareunia/diagnóstico , Dispareunia/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Noruega , Ambulatório Hospitalar/estatística & dados numéricos , Estudos Retrospectivos , Doenças da Vulva/diagnóstico , Doenças da Vulva/terapia , Vulvite/diagnóstico , Vulvite/terapia , Vulvovaginite/diagnóstico , Vulvovaginite/terapia
18.
J Sex Marital Ther ; 30(3): 125-39, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15205070

RESUMO

Vulvar vestibulitis syndrome (VVS) is a heterogeneous, multisystemic, and multifactorial disease and is one of the leading causes of dyspareunia in fertile women. As a multisystemic disease, it involves the mucous structure of the vulvar vestibule and the immune, muscular, vascular, and nervous systems, including pain fibers and centers. As a multifactorial disease, its etiology is complex, involving biological, psychosexual, and relational factors. In this article, we discuss the progression of the disease and the impact of an often lengthy delay between the onset of symptoms and a correct diagnosis. Moreover, despite documented improvements from available treatments, VVS becomes a chronic disease unless it is diagnosed early and an integrated, pathophysiologically oriented treatment is offered in an experienced center. Health care providers would therefore benefit from approaching the condition within a pain management framework focused on the woman's chronic pain, the impact on the couple's relationship, and any associated psychological sequelae.


Assuntos
Coito , Vulva/fisiopatologia , Vulvite/diagnóstico , Vulvite/terapia , Saúde da Mulher , Coito/psicologia , Dispareunia/etiologia , Dispareunia/terapia , Feminino , Humanos , Masculino , Dor/etiologia , Manejo da Dor , Síndrome , Vulva/inervação , Vulvite/fisiopatologia , Vulvite/psicologia
19.
J Reprod Med ; 49(2): 105-7, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15018438

RESUMO

OBJECTIVE: To evaluate eventual contact sensitization in 7 patients with plasma cell vulvitis (PCV). STUDY DESIGN: Seven women with PCV underwent patch tests with the Italian standard series and with additional batteries of allergens (perfumes, preservatives, emulsifiers, medicaments and corticosteroid series). RESULTS: One patient experienced a positive reaction t o balsam of Peru and wool alcohol. CONCLUSION: Patch testing is not normally necessary in the management of PCV. However, when a patient with PCV complains of burning or pruritus after application of topical products, patch tests could prove useful.


Assuntos
Testes do Emplastro , Plasmócitos/patologia , Vulvite/patologia , Vulvite/terapia , Adulto , Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dispareunia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Prurido Vulvar/etiologia , Fatores de Tempo
20.
Clin Exp Obstet Gynecol ; 31(4): 279-81, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15672966

RESUMO

OBJECTIVE: To describe the characteristics of a group of couples with unconsummated marriages and highlight the usual causes and factors for successful management. MATERIAL AND METHOD: Couples seen at King Khaled University Hospital, Riyadh, Saudi Arabia, between the years 1996 and 2001 with inability to consummate their marital relationship. RESULTS: A total of 36 couples were seen during the 5-year period. Vaginismus was the primary cause in 63.9% of the cases, erectile dysfunction in 11.2%, severe premature ejaculation in 8.3%, low male sexual desire in 2.7%, and low female sexual desire in 13.9%. A significant correlation was found between the age of the females and low sexual desire and a significant correlation between consanguinity and low sexual desire in the males. CONCLUSION: Dysfunction underlying non consummation of marriage is largely treatable. Adaptation to the situation usually occurs, and associated factors add to the primary cause. Treatment of the underlying dysfunction can challenge the relationship.


Assuntos
Ejaculação/fisiologia , Libido , Casamento , Disfunções Sexuais Fisiológicas/diagnóstico , Vulvite/diagnóstico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aconselhamento Sexual , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Fisiológicas/terapia , Vulvite/terapia
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