Cases reported "Vulvar Diseases"

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1/8. Labial adhesions in a girl with isolated premature thelarche: the importance of estrogenization.

    BACKGROUND: Premature thelarche, a benign condition that affects young girls, has been associated with elevated estrogen levels. On the contrary, labial fusion, a common pediatric gynecological problem, has been associated with low estrogen status. These two conditions are not known to coexist in the same patient. CASE: We report the case of a 2-yr-old girl with premature thelarche and labial fusion occurring contemporaneously. She presented with a 7-month history of perivaginal itchiness and a palpable painless breast bud. Examination revealed unilateral breast enlargement (Tanner stage 2) and partially fused labia minora. Pelvic ultrasound findings and gonadotrophin responses to intravenous LHRH were consistent with a diagnosis of isolated premature thelarche. Furthermore, elevated serum estradiol levels were found. comment: The combination of isolated premature thelarche and labial adhesions in our patient suggests the existence of other factors as well as estrogen insufficiency in the etiology of the latter.
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ranking = 1
keywords = gynecologic
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2/8. Vulvar pyoderma gangrenosum.

    pyoderma gangrenosum is an idiopathic dermatologic disease manifested by painful cutaneous ulceration. The ulcers are characterized by their undermined, violaceous borders and necrotic tissue at the ulcer base. The lesions may have an unusual response to physical manipulation known as pathergy, a phenomenon that is manifested by rapid progression following debridement. pyoderma gangrenosum is frequently associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis, chronic active hepatitis and hematologic malignancies. Conservative wound care and systemic corticosteroids are usually effective therapy. We report the second case in the gynecologic literature of a patient with vulvar pyoderma gangrenosum.
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ranking = 1
keywords = gynecologic
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3/8. Complications of laser therapy in the gynecological patient: a review of four patients.

    Complications of gynecological laser treatment for perineal disease have been seen with increasing frequency. This may be the result of more women undergoing therapy with this method. Four women presenting with unstable perineal scarring are discussed.
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ranking = 5
keywords = gynecologic
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4/8. histiocytosis-X in gynecology: a case presentation and review of the literature.

    A patient is presented with persistent vulvar ulcerations of 15 months' duration. Biopsies of the lesions were diagnostic of histiocytosis-X. Chest x-ray revealed a honeycombed reticulonodular pattern consistent with pulmonary histiocytosis-X. The dehydration test indicated diabetes insipidus. Electron microscopy revealed Langerhan granules characteristic of histiocytes. This patient represents one of approximately two dozen cases in the world literature showing gynecologic manifestations of histiocytosis-X. The presentations, diagnosis, therapy, and prognosis of this disease are discussed.
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ranking = 1
keywords = gynecologic
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5/8. keratoacanthoma of the vulva.

    A 65-year-old white woman noted a "pea-sized" lump of the right labium majus. At the initial examination a few weeks later, the mass was 1.5 cm in maximum diameter. An excisional biopsy was interpreted as well-differentiated squamous cell carcinoma. The biopsy material was subsequently reviewed prior to recommended radical surgery. Upon review, the lesion was interpreted as a keratoacanthoma. No further surgery was performed and the patient has remained free of recurrent disease for over 2 years. This case is presented in an effort to alert gynecologic oncologists and pathologists of the possibility of this lesion occurring on the vulva.
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ranking = 1
keywords = gynecologic
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6/8. Necrotizing fasciitis and progressive bacterial synergistic gangrene of the vulva.

    Necrotizing fasciitis and progressive bacterial synergistic gangrene are two infrequently reported diseases in the gynecologic literature. The author reports 2 cases highlighting the many similarities and some important differences between these clinical entities. diabetes mellitus and arteriosclerosis predispose women to both diseases. Aggressive antibacterial and surgical treatment is imperative.
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ranking = 1
keywords = gynecologic
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7/8. Squamous cell carcinoma in situ arising within lichen planus of the vulva.

    BACKGROUND. lichen planus is a common dermatologic disorder involving the glabrous skin, hair-bearing skin and scalp, nails, and mucous membranes of the oral cavity, penis, and vulva. There have been multiple case reports of squamous cell carcinoma (SCC) developing within lesions of hypertrophic cutaneous lichen planus and erosive oral lichen planus. Recently, there have been several case reports of SCC arising within lesions of the genital mucosa: one case of penile lichen planus, and two cases of vulvar lichen planus. OBJECTIVE. To report a case of SCC in situ developing within erosive vulvar lichen planus. To heighten the awareness, and facilitate the recognition of vulvar lichen planus. RESULTS. We present SCC in situ developing within a lesion of erosive vulvar lichen planus. The patient was treated with simple total vulvectomy by gynecologic surgery. Her vulva remain disease-free 2 years postoperatively. CONCLUSIONS. Vulvar lesions of lichen planus should be recognized and followed closely. In long-standing erosive lesions of the vulva, periodic sampling biopsies should be examined to rule out malignant degeneration.
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ranking = 1
keywords = gynecologic
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8/8. Toxic shock syndrome associated with vulvar necrotizing fasciitis.

    BACKGROUND: Fifty percent of toxic shock syndrome is associated with nonmenstrual etiologies such as postoperative wound infection. CASE: A 44-year-old woman developed necrotizing vulvar fasciitis that was successfully treated with surgical debridement and broad-spectrum antibiotics. However, after improving for 3 days postoperatively, she developed fever, a generalized maculopapular rash, and renal and liver abnormalities. As her condition worsened, she developed hypotension and respiratory distress. After 5 days in the intensive care unit, she gradually improved. Her wound culture from admission grew multiple organisms, including staphylococcus aureus that produced toxic shock syndrome toxin-1. CONCLUSION: Toxic shock may occur in varied gynecologic settings, including pelvic and perineal infection. Successful management requires a prompt and aggressive response to multi-organ system failure.
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ranking = 1
keywords = gynecologic
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