scholarly journals Lichen sclerosus as a variant of limited scleroderma with damage to the anogenital region

2021 ◽  
Vol 24 (3) ◽  
pp. 243-250
Author(s):  
Gayane E. Bagramova ◽  
Elena S. Snarskaya ◽  
Lydia M. Shnakhova ◽  
Yulia A. Semenchak
Keyword(s):  
High Probability ◽  
Lichen Sclerosus ◽  
Vaginal Mucosa ◽  
Anogenital Region ◽  
Pathogenetic Therapy ◽  
Clinical Variants ◽  
Increased Sensitivity ◽  
Limited Scleroderma ◽  
Tract Infections ◽  
Genitourinary Syndrome

Lichen sclerosus is one of the clinical variants of limited scleroderma, a feature of which is the defeat of the anogenital zone. The issues of the etiology and pathogenesis of lichen sclerosus remain not fully understood, despite numerous studies in which the polygenic nature of inheritance and multifactoriality in the implementation of dermatosis are noted. With the progression of the scleroatrophic process and the absence of timely pathogenetic therapy, there is a high probability of the development of comorbid pathology with a whole range of symptoms, such as urinary (dysuria, recurrent urinary tract infections - cystitis, urethritis, cystourethritis), gastrointestinal (pain during defecation, chronic constipation), vaginal severe dryness and increased sensitivity of the vaginal mucosa, burning, itching). Treatment of patients with lichen sclerosus with lesions of the anogenital zone causes great difficulties. In cases of isolated localization of scleroatrophic lesions of anogenital localization, difficulties may arise in the differential diagnosis with diseases of similar localization, such as vitiligo, atrophic lichen planus, basal cell carcinoma, contact dermatitis, nonspecific balanoposthitis, Keir's erythroplasia. Treatment of limited scleroderma, the clinical variant of which is lichen sclerosus, should be multi-course and complex, with the obligatory use of penicillin antibiotics, hyaluronidase-based drugs, drugs that improve microcirculation, vitamins, immunoregulators and physiotherapeutic methods. Thus, early diagnosis and timely pathogenetic therapy contribute to the prevention of the risks of developing genitourinary syndrome, progression of tissue sclerosis, and psychoemotional disorders. This article presents a clinical case of diagnosis and treatment of a patient with lichen sclerosus.

scholarly journals Gender, clinical and topographic features of the localized scleroderma lesions in anogenital area

2020 ◽  
Vol 23 (3) ◽  
pp. 165-173
Author(s):  
Elena S. Snarskaya ◽  
Yulia A. Semenchak
Keyword(s):  
Clinical Symptoms ◽  
Skin Lesions ◽  
Localized Scleroderma ◽  
Steady Increase ◽  
Family Doctors ◽  
Topographic Features ◽  
Anogenital Area ◽  
Clinical Variants ◽  
Limited Scleroderma ◽  
And Gender

Background: Currently, there is an increase in the number of skin lesions of anogenital localization, which is a silent epidemic, both due to the steady increase in the incidence of this pathology, and the interdisciplinary aspect of this problem. Materials and methods: In the article, the authors first analyzed and presented the data of clinical and morphological analysis of 104 patients with various clinical variants of limited scleroderma, on the basis of which the main phenotypic and gender-specific clinical and topographical features of anogenital zone lesions in this group of patients are presented. Results: Scleroatrophic lichen is one of the clinical variants of limited scleroderma, which is characterized by damage to the mucous membranes of the external genitals in both women and men. Lesions of such localization are late and often mistakenly diagnosed by specialists of related disciplines (obstetricians, gynecologists, urologists, family doctors, allergists, cosmetologists), which leads to high risks of developing genitourenal syndrome. Conclusions: The development of scleroatrophic lesions in the anogenital zone is accompanied by pronounced clinical symptoms, including: itching, pain of varying intensity, dysuria, dyspareunia and significant sexual dysfunction.

scholarly journals Catalase Activity is Critical for Proteus mirabilis Biofilm Development, EPS Composition, and Dissemination During Catheter-Associated Urinary Tract Infection

2021 ◽  
Author(s):  
Ashley N. White ◽  
Brian S. Learman ◽  
Aimee L. Brauer ◽  
Chelsie E. Armbruster
Keyword(s):  
Urinary Tract ◽  
Proteus Mirabilis ◽  
Catalase Activity ◽  
Defense Mechanisms ◽  
Extracellular Polymeric Substances ◽  
Key Factor ◽  
Increased Sensitivity ◽  
Tract Infections ◽  
Biofilm Development

Proteus mirabilis is a leading uropathogen of catheter-associated urinary tract infections (CAUTIs), which are among the most common healthcare-associated infections worldwide. A key factor that contributes to P. mirabilis pathogenesis and persistence during CAUTI is the formation of catheter biofilms, which provide increased resistance to antibiotic treatment and host defense mechanisms. Another factor that is important for bacterial persistence during CAUTI is the ability to resist reactive oxygen species (ROS), such as through the action of the catalase enzyme. Potent catalase activity is one of the defining biochemical characteristics of P. mirabilis , and the single catalase gene ( katA ) encoded in strain HI4320 was recently identified as a candidate fitness factor for UTI, CAUTI, and bacteremia. Here we show that disruption of katA results in increased ROS levels, increased sensitivity to peroxide, and decreased biofilm biomass. The biomass defect was due to a decrease in extracellular polymeric substances (EPS) production by the ΔkatA mutant, and specifically due to reduced carbohydrate content. Importantly, the biofilm defect resulted in decreased antibiotic resistance in vitro and a colonization defect during experimental CAUTI. The ΔkatA mutant also exhibited decreased fitness in a bacteremia model, supporting a dual role for catalase in P. mirabilis biofilm development and immune evasion.

scholarly journals Vulvar Craurosis due to Severe Genitourinary Syndrome of Menopause Complicated by Lichen Sclerosus: Two Case Reports and Literature Review

2021 ◽  
Vol 5 (9) ◽  
pp. 01-04
Author(s):  
Marta Pérez Febles ◽  
Victoria Pascual Escudero ◽  
Sonia De Miguel Manso ◽  
María López Pais ◽  
Dakota Viruega Cuaresma ◽  
...  
Keyword(s):  
Case Reports ◽  
Symptom Relief ◽  
Lichen Sclerosus ◽  
Clinical Situation ◽  
Term Treatment ◽  
Genitourinary Syndrome Of Menopause ◽  
Vulvovaginal Atrophy ◽  
Inflammatory Dermatoses ◽  
Long Term Treatment ◽  
Genitourinary Syndrome

Background: Vulvovaginal atrophy affects approximately 45% of middle-aged women, as a result of decreased estrogen circulating levels and is often associated with vulvovaginal discomfort in menopausal patients. The spectrum of adverse consequences makes long-term treatment essential, not only for symptom relief, but also to avoid further complications. These symptoms can even be worsened if other vulvar conditions coexist, such as inflammatory dermatoses. Clinical presentation: We present two cases of patients with severe vulvar atrophy and craurosis, who required vulvo-vaginal opening associated with medical treatment. In both patients, we diagnosed severe genitourinary syndrome of menopause (GSM) complicated by vulvar lichen sclerosus, a very rare clinical situation. In case 1, the symptoms had progressed despite local estrogen treatment for vulvovaginal atrophy, and lichen wasn’t considered in previous check-ups. In contrast, patient nº 2 presented in the ER with impossibility to urinate and was then diagnosed and treated for underlying causes. Conclusions: GSM treatment should be a priority. The absence of improvement or progression of genital atrophy should alert the specialist to the coexistence of other vulvar pathologies.

scholarly journals Vulvar Lichen Sclerosus et Atrophicus in girls

2021 ◽  
Vol 24 (5) ◽  
pp. 356-360
Author(s):  
Leila V. Adamyan ◽  
Sergey M. Sharkov ◽  
Elena V. Sibirskaya ◽  
Laura G. Pivazyan ◽  
Julietta S. Avetisyan
Keyword(s):  
Randomized Clinical Trials ◽  
Clinical Symptoms ◽  
Case Series ◽  
Lichen Sclerosus ◽  
Genetic Mutations ◽  
Lichen Sclerosus Et Atrophicus ◽  
Inflammatory Dermatosis ◽  
Anogenital Region ◽  
Literature Reviews ◽  
Vulvar Lichen Sclerosus

The review is devoted to diagnosing and treating lichen sclerosus (LS), a chronic inflammatory dermatosis with a predisposition to lesions of the anogenital region in girls. An essential role in the aetiology of this form of pathology is attributed to genetic mutations, injuries, infections and autoimmune diseases, and hormonal and local factors. The peak incidence is observed in 4-6 year girls, accounting for 7-15% of all cases of vulvar LS. The main goal of pharmacotherapy for vulvar LS is to relieve clinical symptoms and prevent scarring and adhesions. The authors analyzed international and domestic publications from 2017 to 2021. PubMed and Google Academy databases were used for the search, keywords: lichen sclerosus, girls. The retrospective and prospective cohort, randomized clinical trials, case series and literature reviews, and clinical guidelines were considered. Our review presents modern data on the diagnosis and treatment of SL in girls, which will be useful for both pediatric gynecologists and doctors of related specialties. The first symptoms of LS are usually nonspecific and are misdiagnosed by non-profile specialists. Some symptoms of LS may disappear spontaneously after menarche, and the course of the disease may be latent. This is why it is generally accepted that the epidemiology of LS is underestimated. Despite this, it can be assumed that the etiology and pathogenesis of LS is probably multifactorial. This review describes several leading etiological factors regarding the potential etiopathogenesis of vulvar LS in girls.

scholarly journals Safety and efficacy of a new vaginal gel, Feminilove, for the treatment of symptoms associated with vaginal dryness and vulvovaginal atrophy in women: an in vitro and in vivo study

2021 ◽  
Author(s):  
Albert Gonzalez ◽  
Robert Lee ◽  
Larry Booshehri ◽  
David Grady ◽  
Victoria Vaddi ◽  
...  
Keyword(s):  
Vaginal Mucosa ◽  
Minimal Cell ◽  
Genitourinary Syndrome Of Menopause ◽  
Vaginal Dryness ◽  
Vulvovaginal Atrophy ◽  
Vaginal Gel ◽  
The Impact ◽  
Genitourinary Syndrome

Vaginal dryness is a common condition that is particularly prevalent during and after the menopause and it is one of the most important symptoms associated with vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underreported and undertreated. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. We evaluated the safety and beneficial effects of a new type of estrogen-free vaginal gel, Feminilove BIO-FRESH moisturizing vaginal gel, using in vitro and in vivo experimental tools. Our results suggest that; 1) Feminilove vaginal gel exhibits minimal cell cytotoxicity on various human vaginal cells; 2) Feminilove vaginal gel exhibits minimal side-effects on the structure of vaginal mucosa stratum of experimental animals; 3) Feminiove vaginal gel inhibits the growth of pathogenic vaginal bacteria (E. coli) while promotes the growth of beneficial vaginal bacteria (Lactobacillus spp); 4) Feminilove vaginal gel elicits an anti-inflammatory response on vaginal epithelial cells; and 5) Feminilove vaginal gel promotes the production of tropoelastin and collagen on cultural vaginal smooth muscle and may restore loose vaginal wall (i.e., tightening effects). In summary, our results indicate that Feminilove BIO-FRESH moisturizing vaginal gel is a safe and effective remedy for the treatment of symptoms associated with vaginal dryness and vulvovaginal atrophy in women. Keyword: vaginal dryness, vulvovaginal atrophy, genitourinary syndrome of menopause, sexual dysfunction, vaginal lubrication, vaginal moisturizer

scholarly journals Effects of Intravenous Ketamine Infusions in a Neuropathic Pain Patient with Lichen Sclerosus et Atrophicus

2016 ◽  
Vol 8 (2) ◽  
pp. 166-172 ◽  
Author(s):  
Ashraf F. Hanna ◽  
Josh S. Armstrong ◽  
Adam J. Smith
Keyword(s):  
Therapeutic Option ◽  
Lichen Sclerosus ◽  
Pain Syndrome ◽  
Opioid Therapy ◽  
Pain Patient ◽  
Lichen Sclerosus Et Atrophicus ◽  
Clinical Observations ◽  
Anogenital Region ◽  
Patient Reported ◽  
Intravenous Ketamine

A patient reported to the Florida Spine Institute (Clearwater, Fla., USA) with severe lichen sclerosus of the anogenital region and legs. The patient’s pain presentation was neuropathic with hypersensitivity, allodynia, swelling, and weakness. The patient had failed multiple pain management modalities including opioid therapy, anticonvulsants, and antidepressants. The patient completed a standard intravenous ketamine infusion regimen developed at the Florida Spine Institute and reported complete abolishment of her pain syndrome. For the first time, we report that ketamine infusions also dramatically improved a patient’s lichen sclerosus. That ketamine is known to have immunomodulatory properties, and given the clinical observations described in this case report, suggests that ketamine should be explored as a possible new therapeutic option for managing lichen sclerosus, especially in cases that are refractory to conventional therapies.

scholarly journals Diabetic neuropathies

2000 ◽  
Vol XXXII (3-4) ◽  
pp. 59-67
Author(s):  
E. I. Bogdanov ◽  
V. V. Talantov ◽  
R. Z. Mukhamedzyanov
Keyword(s):  
Detection Rate ◽  
Early Stage ◽  
Diabetic Neuropathies ◽  
Myocardial Infarctions ◽  
Diabetic Patients ◽  
Treatment And Prevention ◽  
Patients With Diabetes ◽  
Pathogenetic Therapy ◽  
Clinical Variants

Diabetic neuropathies (DN) are among the most frequent and serious complications of diabetes [57, 9]. The detection rate of DN in diabetic patients varies greatly depending on their type, selected clinical and instrumental diagnostic criteria and, according to various researchers, ranges from 10 to 90% [16, 33]. At the same time, 1/3 of the polyneuropathies recognized in the neurological clinic are diabetic. In about 10% of cases, neuropathic symptoms are key in the diagnosis of diabetes [25]. DN has not only severe subjective manifestations and pronounced impairments that are objectively detected in them, but also leads to the development of diabetic foot syndrome - the cause of 50 - 70% of cases of all non-traumatic amputations of the legs [3]. In addition, in patients with diabetic visceral autonomic neuropathy, the syndrome of "sudden death" is much more common, and the frequency of painless myocardial infarctions and ischemic strokes is high. Clinical variants of DN are often the main causes of reduced quality of life, disability and disability in patients with diabetes mellitus. It is extremely important to diagnose the early stage of DN, when it is easier to achieve a therapeutic effect through the earliest and most stable provision of optimal control of an adequate level of glycemia and the appointment of means of pathogenetic therapy. Isolation of forms of DN, their diagnosis, treatment and prevention is an urgent clinical task.

scholarly journals DIAGNOSIS OF ACUTE RESPIRATORY VIRAL INFECTIONS: CLINICAL AND EPIDEMIOLOGICAL REGULARITIES

2019 ◽  
Vol 24 (2) ◽  
pp. 61-68
Author(s):  
Sergej L. Kolpakov ◽  
A. F. Popov ◽  
A. I. Simakova
Keyword(s):  
High Probability ◽  
Respiratory Tract Infections ◽  
Viral Infections ◽  
Specific Weight ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Average Value ◽  
Upper Respiratory ◽  
Respiratory Viral Infections ◽  
Tract Infections

Data on identification and verification of the etiologically diagnosis of a acute respiratory viral infections are presented in article at sharp upper respiratory tract infections of the multiple and not specified localization and at local diseases of respiratory organs in Vladivostok. The highest average value of detectability from 2011 for 2017 was at a rinoviral infection - 22,8 cases %ооо. The detectability of flu A (H3N2) was 19,6%ooo; flu A (H1N1) - 15,1%ooo; flu B - 9,8%ooo. Detection of the acute respiratory viral infections verified on an etiology had natural seasonality. The incidence of flu, caused by representatives of the Orthomyxoviridae family, was formed in the winter and in the spring. During the summer-autumnal period rise in incidence of Paramyxoviridae family viruses was formed (paraflu, RS-viral infection, a metapneumoviral infection). The Coronaviral infection had winter seasonality. The Rinoviral infection, adenoviral and bakaviral infections were characterized by summer-autumnal seasonality. According to the nature of seasonality and structure of the verified cases on months of year the probability of confirmation of the diagnosis of a rinoviral infection from May to October was from 56,8+5,1% to 62,1+7,5%. Similar situation develops with paraflu. From May to November the specific weight of the verified paraflu was from 11,6+4,9% to 19,5+4,9% of all confirmed SARS cases. For flu A (H1N1) the probability of confirmation of the diagnosis from December to March is from 15,4+3,9% to 54,8+5,3%. And at flu A (H3N2) in data of month - from 5,2+2,4% to 47,6+4,0%. At flu B high probability of confirmation of the diagnosis in spring months, in March and April, 30,0+3,6% and 26,4+5,2%.

scholarly journals Species distribution of Enterobacteriaceae and non-Enterobacteriaceae responsible for urinary tract infections at the Zainoel Abidin Hospital in Banda Aceh, Indonesia

2021 ◽  
Vol 22 (8) ◽  
Author(s):  
Suhartono Suhartono ◽  
Wilda Mahdani ◽  
Zinatul Hayati ◽  
NURHALIMAH NURHALIMAH
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Species Distribution ◽  
Pathogenic Bacteria ◽  
Antibiotic Sensitivity ◽  
High Sensitivity ◽  
Vaginal Mucosa ◽  
Gram Positive ◽  
Tract Infections ◽  
Banda Aceh

Abstract. Suhartono S, Mahdani W, Hayati Z, Nurhalimah N. 2021. Species distribution of Enterobacteriaceae and non-Enterobacteriaceae responsible for urinary tract infections at the Zainoel Abidin Hospital in Banda Aceh, Indonesia. Biodiversitas 22: 3313-3318. Urinary tract infection (UTI) is an infection that occurs along the urinary tract caused by pathogenic bacteria. Enterobacteriaceae and non-Enterobacteriaceae are generally normal flora originating from the large intestine and vaginal mucosa. This study aimed to assess the distribution of Enterobacteriaceae and non -Enterobacteriaceae pathogens that cause UTI based on species diversity, patient age, gender, and hospital units, and to evaluate their antibiotic sensitivity to uropathogens in ZAH. In total, there were 284 isolates classified as UTI pathogens with 178 Enterobacteriaceae isolates dominated by Escherichia coli and 107 non- Enterobacteriaceae isolates. Non- Enterobacteriaceae consisted of 77 isolates of Gram-positive dominated by Enterococcus faecalis and Enterococcus facium, and 29 isolates of Gram-negative dominated by Acinetobacter baumannii. The highest UTI ratio was found in the elderly (56-65 years), namely 66.2% Enterobacteriaceae and 33.8% non-Enterobacteriaceae isolates. Based on gender, females were infected with Enterobacteriaceae (66.86%) and non-Enterobacteriaceae (37.41%). Most of UTI patients in the internal medicine unit were infected with Enterobacteriaceae (55.36%) and non-Enterobacteriaceae (44.64%). Amikacin, meropenem, and levofloxacin were antibiotics that had high sensitivity against Enterobacterial and non-Enterobacterial uropathogens. The emergence of Gram-positive uropathogens need to be concerned as these groups start emerging. It is also important to monitor regularly the antibiotic susceptibility of bacterial UTI pathogens to ensure the efficacy of current UTI treatments and minimize the UTI incidence in nosocomial settings.

Sign in / Sign up

Export Citation Format

Share Document