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Vulvar Dermatitis

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21. Treatment of vulvar Paget disease with topical imiquimod: a case report and review of the literature Full Text available with Trip Pro

Treatment of vulvar Paget disease with topical imiquimod: a case report and review of the literature Extramammary Paget's disease is a cutaneous neoplasm that presents as erythematous crusted patches and plaques reminiscent of contact dermatitis or inverse psoriasis that can be a challenge to treat in a tissue-sparing manner. The most commonly involved site for this rare disorder is the anogenital region. Surgery is considered as the gold standard therapy. In the last years, the topical use

2011 Journal of dermatological case reports

22. ASTRO Guideline on Definitive and Postoperative Radiation Therapy for Basal and Squamous Cell Cancers of the Skin

are several related topics, including RT and systemic therapy in the setting of metastatic BCC and cSCC, dermatopathologic aspects of skin cancer diagnosis, nuances of surgical management and the technical details of radiation delivery for skin cancer. Additionally, this guideline does not pertain to the management of mucosal head and neck squamous cell carcinoma, vulvar, penile, or perianal skin carcinoma. Table 2. KQs in Population, Intervention, Comparator, Outcome (PICO) format KQ Population (...) is beneficial for this population. RT, like all cancer interventions, carries risks. For RT this includes acute dermatitis, dryness, permanent local alopecia, telangiectasias and – in rare cases – secondary malignancy. 30 Two important principles for RT treatment are that (1) histologic confirmation is required prior to initiation of treatment and (2) overall life expectancy should be considered and discussed with younger patients, for whom a larger lifetime risk of developing secondary malignancy

2020 American Society for Radiation Oncology

23. Assessment of dyspareunia

in the pelvis. Differentials Vaginitis and vulvovaginitis Herpes simplex infection Vaginal atrophy Iatrogenic Primary inadequate lubrication Vestibulodynia/vulvodynia Endometriosis Adenomyosis Leiomyomas Interstitial cystitis Urinary tract infection Bartholin's gland abscess Seminal plasma hypersensitivity Contact dermatitis Atopic dermatitis Bartholin's gland mass Imperforate hymen Traumatic perineal injuries Vulvar dystrophies Vaginismus Psychosexual disorder Cervicitis Pelvic inflammatory disease

2018 BMJ Best Practice

24. Canadian Urological Association guideline for the diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction

conversion to a suprapubic catheter in the setting of significant urethral damage (GOR A, LOE 3) and ideally before the urethra has been irreversibly dam- aged and there is a risk of stress incontinence. 62 Sexuality is adversely affected for 40–91% of patients with neurogenic bladder, 67 and incontinence is a significant contributing factor due to fear of leakage during intercourse, embarrassment, concerns about odours, dyspareunia from vulvar irritation, or dermatitis from chronic leakage. 68 Side

2019 Canadian Urological Association

25. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU

, urethral diverticulum, Skene’s gland cyst, or other enlarged or infected vulvar or vaginal cysts, and a focused examination to document any other infectious and inflammatory conditions, such as vaginitis, vulvar dermatitis, and vaginal atrophy

2019 Canadian Urological Association

26. Mometasone

performed a two-stage, parallel, randomized, double-blind, double-dummy, clinical trial with 240 AH children with concomitant perennial AR. During the first stage, all children were randomly assigned to the MF or control group for six weeks of treatment. During the second stage, the non 2017 11. Continuous versus tapering application of the potent topical corticosteroid mometasone furoate in the treatment of vulvar lichen sclerosus: results from a randomized trial. 26280156 2015 12 28 2016 10 05 2016 12 (...) 30 1365-2133 173 6 2015 Dec The British journal of dermatology Br. J. Dermatol. Continuous vs. tapering application of the potent topical corticosteroid mometasone furoate in the treatment of vulvar lichen sclerosus: results of a randomized trial. 1381-6 10.1111/bjd.14074 Topical (...) corticosteroids are the first-line treatment for vulvar lichen sclerosus (VLS). However, evidence on the most appropriate treatment regimen is lacking. To compare the effectiveness and tolerability of tapering vs

2018 Trip Latest and Greatest

27. Recurrent Uncomplicated Urinary Tract Infections in Women

. A focused examination to document any other infectious and inflammatory conditions, such as vaginitis, vulvar dermatitis, and vaginal atrophy (genitourinary syndrome of menopause) should also be performed. The pelvic floor musculature should be examined for tone, tenderness, and trigger points. 74 A focused neurological exam to rule out occult neurologic defects may also be considered. Evaluation for incomplete bladder emptying to rule out occult retention can be considered for all patients, but should (...) , a 10 5 CFU/mL threshold for bacterial growth on midstream voided urine may help distinguish bladder bacteriuria from vaginal contamination in asymptomatic, pre-menopausal women, but a lower 10 2 CFU/mL threshold may be appropriate in symptomatic individuals. Disorders such as interstitial cystitis/bladder pain syndrome, OAB, genitourinary syndrome of menopause, urinary calculi, infectious bacterial or fungal vaginitis, vulvar dermatitis, non-infectious vulvovestibulitis, vulvodynia, hypertonic

2019 American Urological Association

28. Pruritus

dermatitis (AD). Pruritus may be the result of a dermatological or non-dermatological disease. Especially in non-diseased skin it may be caused by systemic, neurological or psychiatric diseases, as well as being a side effect of medications. In a number of cases CP may be of multifactorial origin. Pruritus needs a precise diagnostic work-up. Management of CP comprises treatment of the underlying disease and topical treatment modalities, including symptomatic antipruritic treatment, ultraviolet (...) : experts in the field from Europe. More than 30% are European Academy of Dermatology and Venereology (EADV) members 3 Abbreviations and explanations AD Atopic dermatitis AEP Atopic eruption of pregnancy CGRP Calcitonin gene-related peptide CKD Chronic kidney disease CNS Central nervous system CNPG Chronic nodular prurigo CP Chronic pruritus (longer than 6 weeks) CPG Chronic prurigo CSU Chronic spontaneous urticaria DIF Direct immunofluorescence ICP Intrahepatic cholestasis of pregnancy IFSI

2019 European Dermatology Forum

29. Chronic Pelvic Pain

cystitis. Urology, 2007. 70: 16. 153. Reissing, E.D., et al. Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome. J Psychosom Obstet Gynaecol, 2005. 26: 107. 154. Nickel , J., et al. Management of men diagnosed with chronic prostatitis/chronic pelvic pain syndrome who have failed traditional management. Rev Urol, 2007. 9: 63. 155. Nickel, J.C., et al. Chronic Prostate Inflammation Predicts Symptom Progression in Patients with Chronic Prostatitis/Chronic Pelvic Pain. J Urol, 2017

2019 European Association of Urology

30. Guidelines for the Management of Genital, Anal and Throat HPV Infection in New Zealand

Human Papillomavirus LSIL Low-grade Squamous Intraepithelial Lesion MSM Men who have Sex with Men NCSP National Cervical Screening Programme PCR Polymerase Chain Reaction amplification PIN Penile Intraepithelial Neoplasia RRP Recurrent Respiratory Papillomatosis SCC Squamous Cell Carcinoma SIL Squamous Intraepithelial Lesion STI Sexually Transmitted Infection TCA Trichlorocetic Acid VaIN Vaginal Intraepithelial Neoplasia VIN Vulvar Intraepithelial Neoplasia VLP Virus-Like Particle2 WHAT’S NEW

2017 New Zealand Sexual Health Society

31. Guidelines for the Management of Genital Herpes in New Zealand

of determining that the patient has a recurrent episode, but other genital conditions may mimic and/or coexist with recurrent herpes, and careful examination of the genitalia should always form part of the diagnostic procedure. • Common differential diagnoses include lichen sclerosus, fissuring due to candidiasis, folliculitis, bacterial skin infections, dermatitis and any other skin conditions that cause itching and fragility of the skin. • Uncommon conditions include erythemea multiforme, hidradenitis

2017 New Zealand Sexual Health Society

32. Lichen Sclerosus

(scleros* or atrophi* or albu* or scleureu* or sclero-atrophi* or vulva* or genita*)).ab,ti. 3. "white spot* diseas*".ab,ti. 4. exp Vulvar Lichen Sclerosus/ 5. "kraurosi* vulva*".ab,ti. 6. (vulva* and (atroph* or dystroph*)).ab,ti. 7. exp Balanitis Xerotica Obliterans/ 8. balaniti* xerotic* oblitera*.ab,ti. 9. "kraurosi* peni*".ab,ti. 10. 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 11. Randomized Controlled Trials as Topic/ 12. randomized controlled trial/ 13. Random Allocation/ 14. Double-Blind Method (...) (blind$3 or mask$3)).tw. 29. Placebos/ 30. placebo$.tw. 31. randomly allocated.tw. 32. (allocated adj2 random$).tw. 33. 27 or 28 or 29 or 30 or 31 or 32 34. 26 or 33 35. case report.tw. 36. letter/ 37. historical article/ 38. 35 or 36 or 37 39. 34 not 38 40. 10 and 39 MEDLINE search for case reports 1. exp Lichen Sclerosus et Atrophicus/ 2. (lichen adj3 (scleros* or atrophi* or albu* or scleureu* or sclero-atrophi* or vulva* or genita*)).ab,ti. 3. "white spot* diseas*".ab,ti. 4. exp Vulvar Lichen

2018 European Dermatology Forum

33. Lichen Planus

and is rare in children. The lesions usually involve the skin (cutaneous lichen planus), the oral cavity (oral lichen planus), the genitalia (penile or vulvar lichen planus), the scalp (lichen planopilaris), nails (lichen unguis), or extra-cutaneously (e.g. the esophagus). The diagnosis and management of lichen planus will be reviewed here. Despite the high prevalence of the disease and the variety of therapeutic options available, no national or international evidence-based guidelines for treatment exist (...) host disease Lichen striatus, Linear epidermal nevus, Nevus unius lateralis • Eczema, Lichen simplex chronicus, Prurigo nodularis 9 • Pityriasis rosea, Guttate Psoriasis, Psoriasis vulgaris, Ekzematid-like Purpura • Drug eruption, Syphilis, Tinea corporis, Papular acrodermatitis of childhood • Granuloma annulare, Lichen amyloidosus, Pityriasis lichenoides, Kaposi sarcoma Table 1. Differential diagnosis of site-specific LP Nail Psoriasis, onychomycosis, alopecia areata, atopic dermatitis Genital

2018 European Dermatology Forum

34. Chronic Pelvic Pain

cystitis. Urology, 2007. 70: 16. 153. Reissing, E.D., et al. Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome. J Psychosom Obstet Gynaecol, 2005. 26: 107. 154. Nickel , J., et al. Management of men diagnosed with chronic prostatitis/chronic pelvic pain syndrome who have failed traditional management. Rev Urol, 2007. 9: 63. 155. Nickel, J.C., et al. Chronic Prostate Inflammation Predicts Symptom Progression in Patients with Chronic Prostatitis/Chronic Pelvic Pain. J Urol, 2017

2018 European Association of Urology

36. British Association of Dermatologists' guidelines for the safe and effective prescribing of methotrexate for skin disease

a clinically signi?cant difference between the two groups. In an open-label study of 60 patients with a very diverse range of eczematous disorders, a 68% mean reduction in Eczema Area and Severity Index score was reported in those given MTX in doses of up to 75 mg weekly (n = 30) com- pared with a 21% reduction in those given just folic acid 5 mg daily (n = 30). 15 In this study, 40% of patients had ato- pic eczema, 31% had contact dermatitis, 12% had pompholyx, 8% had seborrhoeic dermatitis, 5% had lichen (...) simplex chroni- cus and 3% had discoid eczema. The study lacks detail about how the patients were randomized, and was further limited by a lack of dose escalation, and the short duration of eczema ?are-up in some patients. An open-label, noncontrolled prospective study of 12 patients showed an average of 54% improvement in six-area, six-sign atopic dermatitis (SASSAD) score at 12 weeks with a median dose of 15 mg weekly. 16 MTX was found to be well tolerated in this group with no serious adverse

2016 British Association of Dermatologists

37. Chronic Pelvic Pain

Clinical examination 35 4.3.1 Investigations 35 4.4 Pain associated with well-defined conditions 35 4.4.1 Dysmenorrhoea 35 4.4.2 Infection 35 4.4.3 Endometriosis and adenomyosis 36 4.4.4 Gynaecological malignancy 36 4.4.5 Injuries related to childbirth 36 4.4.6 Pain associated with pelvic organ prolapse and prolapse surgery 36 4.5 Vaginal and vulvar pain syndromes 37 4.6 Managing chronic gynaecological pain in ill-defined conditions 37 4.7 Summary 37 4.7.1 Conclusions and recommendations (...) passed a renal stone, somatic muscle hyperalgesia is frequently present, even a year after expulsion of the stone. Pain to non-painful stimuli (allodynia) may also be present in certain individuals. Somatic tissue hyperaesthesia is associated with urinary and bilary colic, IBS, endometriosis, dysmenorrhoea, and recurrent bladder infection. Vulvar pain syndromes are examples of cutaneous allodynia that, in certain cases, may be associated with visceral pain syndromes, such as BPS. Referred pain

2015 European Association of Urology

38. Chronic vulvar irritation: could toilet paper be the culprit? Full Text available with Trip Pro

Chronic vulvar irritation: could toilet paper be the culprit? 20393094 2012 03 26 2018 11 13 1715-5258 56 4 2010 Apr Canadian family physician Medecin de famille canadien Can Fam Physician Chronic vulvar irritation: could toilet paper be the culprit? 350-2 Majerovich Jo Ann JA Student Health Services, University of New Brunswick, Fredericton, NB E3B 5N5. Canty Andrea A Miedema Baukje B eng Case Reports Journal Article Canada Can Fam Physician 0120300 0008-350X 0 Bleaching Agents IM Bleaching (...) Agents toxicity Chronic Disease Female Humans Hygiene Middle Aged Paper Remission, Spontaneous Vulvovaginitis chemically induced 2010 4 16 6 0 2010 4 16 6 0 2012 3 27 6 0 ppublish 20393094 56/4/350 PMC2860827 Am Fam Physician. 2001 Feb 15;63(4):697-702 11237084 Am Fam Physician. 2000 Jun 1;61(11):3306-12, 3317 10865926 Int J STD AIDS. 2002 Aug;13(8):522-39 12194734 J Am Med Womens Assoc. 2003 Spring;58(2):82-8 12744420 Curr Opin Obstet Gynecol. 2003 Dec;15(6):497-500 14624216 Contact Dermatitis. 1979

2010 Canadian Family Physician

39. Pruritus vulvae

good clinical practice. CKS considers that in the absence of a known cause, a general treatment approach should be considered. A general treatment approach, including restoring the skin barrier, reducing inflammation, symptomatic relief, and preventing and treating secondary infection has the potential to address vulvar symptoms caused by eczematous dermatitis, lichen simplex chronicus, and allergic or irritant contact dermatitis [ ]. This approach also may significantly improve symptoms of lichen (...) reviews Vulvar dermatoses: a practical approach to evaluation and management [ ], Recognition and management of vulvar dermatologic conditions: lichen sclerosus, lichen planus, and lichen simplex chronicus [ ], and the 2016 European guideline for the management of vulval conditions [ ]. This CKS topic covers the initial management of adult women presenting with the symptom of vulval itch (pruritus vulvae). It contains advice on diagnosis and general symptomatic treatment for vulval conditions

2017 NICE Clinical Knowledge Summaries

40. UK national guideline for the management of Genital Molluscum in adults

in the setting of immunocompromise. (14) (21-22) Other uncommon manifestations include cystic, cellulitis or abscess-like lesions, (14) (23-27) cutaneous pseudo-lymphomas, (28-31) folliculitis (32- 33) or warty appearances. (34) Commonly, patients have 1-30 individual lesions at a time, (35) occurring as clusters, and these can become koebnerised. Especially lesions in later stages, at point of regression, can be surrounded by an inflammatory dermatitis. (36-37) Molluscum infection can affect almost any part (...) (93-94) 5 and vulvar lymphangioma circumscriptum. (95-96) Patients may confuse genital lesions with genital warts. The most significant differential diagnoses of molluscum however are the cutaneous manifestations of disseminated fungal infections, usually presenting in late immunosuppression, including Penicilliosis, (97-99) Cryptococcosis, (100-108) Histoplasmosis, (109-110) Coccidiodomycosis, Pneumocystis carinii (111) and Aspergillosis. (112) Management General advice Patients must be warned

2014 British Association for Sexual Health and HIV

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