1/13. hypnosis in a case of long-standing idiopathic itch. OBJECTIVE: This article presents the results of a brief hypnosis treatment of a woman with chronic, idiopathic vaginal and anal itch. methods: The patient was referred after 3 years of unsuccessful outcomes with standard topical and oral treatments prescribed by her family physician and three dermatologists. Treatment consisted of five sessions of self-hypnosis training in techniques of relaxation, deepening, and imagery, and home practice with an individualized instructional tape. RESULTS: After treatment, the patient reported substantial tissue healing, confirmed by her treating physician, that coincided with significant reductions in her scores of itch intensity, itch-related sleep disruption, and distress from pre- to posttreatment. These improvements continued at 4 months of follow-up, and the patient reported complete resolution of physical symptoms. CONCLUSIONS: The fact that these changes coincided with only minor improvements in general anxiety scores suggests that the resolution of the patient's itch condition was treatment-specific rather than the result of methodological artifact, participant reporting bias, or a general sense of feeling better. These findings suggest that hypnosis is a cost-effective treatment for idiopathic itch conditions, especially those that are unresponsive to standard medical treatments. ( info) |
2/13. Vulvar syringoma causing pruritus and carcinophobia: treatment by argon laser. Syringomas are benign lesions most commonly appearing around the eyelids and in malar areas, but they have also been described on other body sites. Depending on the site they may cause either aesthetic disturbance (e.g. face, neck, arms) or pruritus (e.g. vulva). This is the first report of argon laser treatment of syringoma in a patient with multiple vulvar syringomas in association with pruritus vulvae and carcinophobia. ( info) |
3/13. Papular acantholytic dyskeratosis of the vulva. We describe two patients with unusual asymptomatic, papular lesions on the vulva, clinically resembling lichen planus, the histology of which revealed unexpected findings of suprabasilar clefting, acantholysis and dyskeratotic cells giving rise to corps ronds and grains together with hyperkeratosis and parakeratosis, features originally associated with a diagnosis of Darier's disease. Focal acantholytic dyskeratosis has been described in a wide variety of inflammatory and neoplastic processes including those involving mucous membranes and has been attributed various diagnostic labels. We feel that the findings in our patients are consistent with a diagnosis of papular acantholytic dyskeratosis of the vulva, a rare condition, which was first described in 1984. ( info) |
4/13. Long retained intravaginal foreign body: a case report. Recurrent vaginal discharge in children may be due to variety of causes. Intravaginal foreign body retained for long duration can be a diagnostic dilemma. This report presents the case of a girl who had an intravaginal foreign body for over four years duration. Recurrent, unremitting, foul-smelling, bloody vaginal discharge in a child should alert the clinician to the possibility of a retained vaginal foreign body. ( info) |
| A case of syringoma of the vulva causing severe vulval pruritus is presented. The patient was thought to have either vulval dystrophy or nonspecific inflammation. Unexpectantly the diagnosis of syringoma was made on pathological examination of biopsy specimens. This unusual case is presented as the presenting symptoms and macroscopic appearance was atypical for syringoma. ( info) |
6/13. Childhood anogenital lichen sclerosus. A case report. Childhood lichen sclerosus is a rare disorder. A 4-year-old girl with chronic vulvar pruritus who was initially suspected to be the victim of child abuse was treated. Vulvar biopsy was performed, confirming the diagnosis of lichen sclerosus. The child was treated with 2% progesterone cream, with complete resolution of her pruritic symptoms and signs of traumatic injury to the vulvar skin. The basic condition, lichen sclerosus, has persisted. ( info) |
| lichen planus is an uncommon cutaneous disease that can affect the vulva. Vulvar pruritus and pain are common symptoms in patients with genital involvement. Examination reveals an erythematous, friable vestibule with adherent exudate. Marked resorption of the labia minor and atrophy may occur in time. diagnosis is based on associated clinical findings involving the oral mucosa and/or the skin and on vulvar biopsy. ( info) |
| A female of 66 who presented with long-standing pruritus vulvae showed angiokeratoma of the vulva as an incidental finding. This benign tumour is uncommon and in a survey of 150 patients over 50 years old (mean age 76.9), no further example was found. ( info) |
9/13. Treatment of lichen sclerosus with potassium para-aminobenzoate. In five patients with symptomatic lichen sclerosus, significant clinical improvement was obtained following the administration of potassium para-aminobenzoate. Improvement was characterized by a marked decrease or absence of symptoms and a flattening of skin lesions. ( info) |
| syringoma of the vulva is a rare disorder. The patient presented here is the seventh case in the American literature; she is the only patient with this condition in a series of 1132 women with vulvar disease. Differential diagnosis includes epidermal cyst, cherry hemangioma, angiokeratoma, comedo, soft fibroma, fox-fordyce disease, steatocystoma multiplex, and lymphangioma circumstriptum. Although syringoma is usually an incidental finding, the diagnosis should be considered in patients with pruritus vulvae. In such cases, examination of the skin around the eyelids and malar areas where syringoma occurs more commonly may suggest a diagnosis of vulvar syringoma that can be confirmed by histologic examination. Inspection of the vulva in cases with extragenital involvement may lead to a more frequent diagnosis of vulvar syringoma. ( info) |