1,721,015 research outputs found
When traditional Chinese medicine runs on WhatsApp®
No full textThis case emphasizes how the procedures of traditional Chinese medicine may cause dermatological patterns which may lead to a misdiagnosis especially in physicians not familiar with complementary and alternative medicine. Furthermore the only use of clinical images transmitted by mobile phone platforms such as WhatsApp® may interfere with a correct diagnosis when they are not supported by a complete medical history and physical assessment
Combining topical tretinoin with mometasone furoate in the treatment of vulvar lichen sclerosus: Results of dermoscopic assessment
No full textThe main purpose of the present study was to compare the dermoscopic changes on vulvar lichen sclerosus (VLS) induced by two different 12-week treatment protocols, namely mometasone furoate 0.1% ointment plus tretinoin 0.05% cream in short-contact therapy (group A) versus the same corticosteroid plus emollient (group B). All dermoscopic images captured before and after treatment were assessed. Each dermoscopic variable selected for the study purpose was arbitrarily graded according to a 4-point scale by dermatologists blinded to both the time at which the images were captured and treatment allocation. Seventeen patients in group A and 15 in group B were included. The vessel mean dermoscopic scores increased significantly after treatment, whereas the scores of (a) patchy, structure-less, whitish areas, (b) whitish background, (c) comedo-like openings, and (d) purpuric blotches decreased. At the control visit, the two protocols did not differ significantly for any of the dermoscopic parameters, both in terms of mean score change and in the number of patients showing changes. Although the complementary action of the two molecules may suggest a therapeutic benefit, the association of tretinoin in short contact therapy with a potent corticosteroid did not induce significant changes in the dermoscopic features of VLS compared with the same corticosteroid alone
Prospective clinical and epidemiologic study of vulvar lichen sclerosus: analysis of prevalence and severity of clinical features, together with historical and demographic associations.
No full textBackground: Few reports have addressed the associations
between clinical, demographic and historical variables of
vulvar lichen sclerosus (VLS). Objective: To elaborate the
prevalence and severity of signs and symptoms and to identify
potential factors predicting the severity and course of
VLS. Methods: A prospective cohort of 225 patients affected
by VLS was included. Data were collected by direct interview
and clinical examination. Results: 98% of patients complained
of symptoms, principally itching. Pallor and scarringsclerosis-
atrophy were the most frequent and severe signs.
The severity of VLS signs was not associated with age at onset
and duration of the disease. About 70% of the patients
had previously undergone treatment. Conclusions: VLS-related
symptoms were not associated with the clinical features
which resulted less severe. Personal history of autoimmune
diseases and familial history of VLS did not influence
the age at onset and the severity of VLS. A considerable part
of patients had previously received inappropriate treatment
Cheiliti da contatto
No full texté stata condotta una indagine retrospettiva su pazienti con cheilite da contatto. La maggior parte delle cheiliti è risultata di natura irritativa; le cheiliti allergiche rappresentavano il 24,2%
Continuous vs. tapering application of the potent topical corticosteroid mometasone furoate in the treatment of vulvar lichen sclerosus: Results of a randomized trial
No full textBACKGROUND: Topical corticosteroids are the first-line treatment for vulvar lichen sclerosus (VLS). However, evidence on the most appropriate treatment regimen is lacking.
OBJECTIVES: To compare the effectiveness and tolerability of tapering vs. continuous application of mometasone furoate (MMF) 0·1% ointment in the treatment of active VLS.
METHODS: Sixty-four patients with VLS who enrolled in a 12-week active treatment phase were randomized to apply MMF either (i) once daily for 5 days per week for 4 weeks, then on alternate days for 4 weeks, then twice weekly for 4 weeks (group A) or (ii) for five consecutive days per week for the entire treatment duration (group B). The efficacy parameters were the response rate, the proportion of patients achieving an improvement from baseline of ≥ 75% in subjective and objective scores, and the mean reduction in subjective and objective scores.
RESULTS: By the end of the active treatment phase, 27 patients (84%) were considered to be responders in group A, and 25 patients (78%) in group B; 69% and 47% of patients in group A and 62% and 28% in group B achieved ≥ 75% improvement in subjective and objective scores, respectively. The decreases in mean symptom and sign scores were significant compared with baseline with both regimens. No significant differences were found in any of the assessed efficacy end points between the two treatment protocols. Both regimens were well tolerated.
CONCLUSIONS: Both tapering and continuous application of MMF showed similar efficacy and tolerability in the treatment of active VLS, without any difference in patient adherence to therapy
Linfangioma circoscritto vulvare: quando le cose si complicano.
No full textIl linfangioma circoscritto (LC), proliferazione benigna dei vasi linfatici
del derma e dell’ipoderma, è la forma più comune di linfangioma
cutaneo. La forma primitiva di LC è presente dalla nascita o comunque
insorge entro i primi anni di vita come risultato di malformazioni congenite
a carico del circolo linfatico; la forma acquisita compare in età adulta
secondariamente ad un danno a carico dei vasi linfatici. Generalmente il
LC si localizza nelle sedi cutanee con una ricca rete linfatici sottostante
(cavi ascellari, inguini, perineo), la localizzazione vulvare, sia per le forme
primitive che per le forme acquisite/secondarie, è rara.
Il LC vulvare acquisito è dovuto a infezioni (malattie a trasmissione
sessuale, tubercolosi, filaria, erisipele), morbo di Crohn, interventi di isterectomia, linfadenectomia o radioterapia pelvica, traumi o ostruzioni
linfatiche da masse neoplastiche.
Gli autori presentano un caso di linfangioma circoscritto vulvare acquisito
in età adulta che non riconosceva alcun fattore causale. Si discute
la gestione clinica, terapeutica ed i provvedimenti chirurgici anche in
relazione alle erisipele ricorrenti insorte come complicanza
Effectiveness of silk fabric underwear as an adjuvant tool in the management of vulvar lichen simplex chronicus: results of a double-blind randomized controlled trial
No full textObjective Avoiding potentially irritating contact is a key point in vulvar lichen simplex chronicus (VLSC) management. This study aims to assess the use of nonirritating silk fabric underwear (Dermasilk) as an adjuvant tool in the treatment of VLSC. Methods Twenty women with VLSC were enrolled in a 1-week open-label active treatment phase with topical 0.1% mometasone furoate (MMF) ointment. Participants then entered a 4-week double-blind maintenance phase (MP) in which they were randomized to wear either silk fabric or cotton briefs. During MP, participants were allowed to use MMF on an "as-needed" basis. The main efficacy endpoints were to assess and compare the two intervention groups on the following: (1) number of participants who needed to apply MMF throughout MP; (2) mean number of MMF applications; (3) mean symptom-free interval before MMF reapplication; and (4) changes in the severity of symptoms and signs. Results During MP, four women in the silk fabric briefs group applied MMF compared with six women in the cotton briefs group (relative risk, 0.66). The mean number of MMF applications was lower in the silk fabric briefs group than in the cotton briefs group (P = 0.074). VLSC symptom-free interval was 22.5 days in the silk fabric briefs group and 7.2 days in the cotton briefs group (P = 0.0003). At the end of MP, symptom improvement determined after corticosteroid use increased in the silk fabric briefs group but worsened in the cotton briefs group. Conclusions Silk fabric underwear may be a useful tool for the management of VLSC by diminishing external sources of irritation and may reduce use of corticosteroids. © 2015 by The North American Menopause Societ
Lichen sclerosus vulvare: caratteristiche clinico-epidemiologiche, fattori di rischio ed elementi prognostici in pazienti seguite c/o l’ambulatorio di patologia vulvare.
No full textDermoscopy of vulvar multiple syringomas: a diagnostic aid for a rare entity
No full textDermoscopy of vulvar syringomas shows peculiar features which can represent an excellent support for a non-invasive diagnosis. We report a paradigmatic case
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