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Vulvar guidelines

Jennifer Gibbs, Shirley Mei, Katherine Economos, Yi-Chun Lee, Margaux J Kanis
BACKGROUND: Primary gynecological neuroendocrine tumors (gNET) are uncommon malignant neoplasms associated with poor prognosis. Clinically these tumors present a significant challenge due to the lack of standardized management guidelines. OBJECTIVE: The objective of this study is to evaluate the clinicopathologic features, incidence and survival trends in gNET. STUDY DESIGN: Surveillance, Epidemiology and End Results (SEER) cancer registry was queried for women diagnosed with primary gNET from 1987-2012...
March 5, 2019: American Journal of Obstetrics and Gynecology
Gowri Dorairajan, Murali S Subbaiah, Esha R Shanbhag
Lymphedema of filarial origin affecting the vulva is extremely rare. It is a dilemma if seen in a pregnant woman as there are no guidelines regarding excision and the mode of delivery. With the World Health Organization-driven global program to eradicate filaria, it is unfortunate to see such cases. We report of a woman who had massive lymphedema of both the labia majora following filarial infection with a small secondary ulcer. She presented to our outpatient department in early pregnancy. After detailed counseling with the couple, a decision was taken for excision...
February 13, 2019: Journal of Obstetrics and Gynaecology Research
Elizabeth Lokich
Survivorship care includes surveillance and prevention of cancer recurrence, addressing side effects of cancer and cancer treatment and coordination of follow-up care. This article reviews guidelines for surveillance of women with ovarian, endometrial, cervical, and vulvar cancer. It also reviews many of the long-term physical side effects of gynecologic cancer treatment including fatigue, neuropathy, lymphedema, cognitive dysfunction, sexual health concerns, menopausal symptoms, infertility, and economic stressors...
March 2019: Obstetrics and Gynecology Clinics of North America
Julie Ann Francis, Lua Eiriksson, Erin Dean, Alexandra Sebastianelli, Boris Bahoric, Shannon Salvador
OBJECTIVE: This guideline reviews the clinical evaluation and management of squamous cell cancer (SCC) of the vulva with respect to diagnosis, primary surgical, radiation, or chemotherapy management and need for adjuvant treatment with chemotherapy and/or radiation therapy. Other vulvar cancer pathologic diagnoses are not included in the guideline. INTENDED USERS: The first part of this document which includes recommendations 1 through 3 is for general gynaecologists, obstetricians, family doctors, registered nurses, nurse practitioners, residents, and health care providers with a focus on the presentation, diagnosis, and updated information about surgical procedures performed by subspecialists...
January 2019: Journal of Obstetrics and Gynaecology Canada: JOGC
Olivia A Charlton, Saxon D Smith
Balanitis xerotica obliterans (BXO), or penile lichen sclerosus, is a progressive sclerosing inflammatory dermatosis of the glans penis and foreskin. It is associated with significant morbidity and may result in impaired urinary and sexual function. It was initially described by Stuhmer in 1928, named after its pathological features, and is considered the male equivalent of vulvar lichen sclerosis (LS). The etiology of BXO is uncertain; however, autoimmune disease, local trauma, and genetic and infective causes have been proposed...
October 12, 2018: International Journal of Dermatology
Pedro Vieira-Baptista, Gutemberg Almeida, Fabrizio Bogliatto, Tanja Gizela Bohl, Matthé Burger, Bina Cohen-Sacher, Karen Gibbon, Andrew Goldstein, Debra Heller, Wendy Likes, Celene Longo da Silva, Claudia Marchitelli, Micheline Moyal-Barracco, Kathleen Posey, Maria Celeste Sluga, Colleen Kennedy Stockdale, Gisele Vissoci Marquini, Kamil Zalewski
Female genital cosmetic surgeries (FGCSs) and procedures are increasingly being advertised as common, simple, and complication-free, capable of not only improving aesthetic appearance but also increasing self-esteem and sexual pleasure.Guidelines for physicians and clear, scientifically correct information for patients must be made available, to minimize the number of ineffective or deleterious procedures.The International Society for the Study of Vulvovaginal Disease positions/recommendations regarding FGCS are as follows:1...
October 2018: Journal of Lower Genital Tract Disease
Kaiane Habeshian, Kylie Fowler, Veronica Gomez-Lobo, Kalyani Marathe
To our knowledge, there are no guidelines in the dermatology literature for performing anogenital examinations in prepubescent children. Based on experience in our joint pediatric dermatology-gynecology vulvar clinic, we aim to provide a framework for conducting genital examinations in children, focusing on the vulvar examination. Our goal is to enhance confidence in the pediatric dermatologist's ability to perform thorough examinations by providing general principles as well as concrete "do's" and "don'ts" that will create a maximally comfortable and productive experience...
September 2018: Pediatric Dermatology
Corina L Buzard, Denise Rizzolo
Anal intraepithelial neoplasia (AIN) and anal squamous cell carcinoma (ASCC) are on the rise in the United States, especially among men who have sex with men, HIV-positive or other immunocompromised patients, and women with a history of cervical, vaginal, or vulvar cancer. Strong evidence supports the human papillomavirus as the causative factor in anal dysplasia; reducing the risk of HPV infection can reduce rates of ASCC. High-risk patients should be screened for AIN, but no universal screening guidelines exist, and more studies are needed to develop a national protocol for screening and management of patients with AIN...
July 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
Peter Vaupel, Helmut Piazena, Werner Müller, Markus Notter
Thermography-controlled, water-filtered infrared-A (wIRA) is a novel, effective and approved heating technique listed in the ESHO quality assurance guidelines for superficial hyperthermia clinical trials (2017). In order to assess the special features and the potential of wIRA-hyperthermia (wIRA-HT), detailed and updated information about its physical and photobiological background is presented. wIRA allows for (a) application of high irradiances without skin pain and acute grade 2-4 skin toxicities, (b) prolonged, therapeutically relevant exposure times using high irradiances (150-200 mW/cm2 ) and (c) faster and deeper heat extension within tissues...
May 10, 2018: International Journal of Hyperthermia
Adrianna I Acevedo-Fontánez, Erick Suárez, Carlos R Torres Cintrón, Ana P Ortiz
OBJECTIVE: The aim of the study was to estimate the magnitude of the association between HPV-related gynecological neoplasms and secondary anal cancer among women in Puerto Rico (PR). MATERIALS AND METHODS: We identified 9,489 women who had been diagnosed with a primary cervical, vaginal, or vulvar tumor during 1987-2013. To describe the trends of invasive cervical, vulvar, vaginal, and anal cancer, the age-adjusted incidence rates were estimated using the direct method (2000 US as Standard Population)...
July 2018: Journal of Lower Genital Tract Disease
Lulu Sun, Lingxin Zhang, Hannah R Krigman, Ian S Hagemann
OBJECTIVES: Preinvasive squamous neoplasms of the lower genital tract are currently classified using a two-tier system (high- or low-grade squamous intraepithelial lesion) as directed by the Lower Anogenital Squamous Terminology (LAST) guidelines but may also be subclassified as intraepithelial neoplasia grade 1 (-IN1), -IN2, or -IN3. The LAST recommended that all diagnoses of -IN2 be supported by immunohistochemistry (IHC) for p16. We examined whether p16 and Ki-67 IHC are necessary to diagnose -IN2 when the lesion has obvious high-grade histology...
April 2018: Journal of Lower Genital Tract Disease
Toshiaki Saito, Tsutomu Tabata, Hitoshi Ikushima, Hiroyuki Yanai, Hironori Tashiro, Hitoshi Niikura, Takeo Minaguchi, Toshinari Muramatsu, Tsukasa Baba, Wataru Yamagami, Kazuya Ariyoshi, Kimio Ushijima, Mikio Mikami, Satoru Nagase, Masanori Kaneuchi, Nobuo Yaegashi, Yasuhiro Udagawa, Hidetaka Katabuchi
BACKGROUND: Vulvar cancer and vaginal cancer are relatively rare tumors, and there had been no established treatment principles or guidelines to treat these rare tumors in Japan. The first version of the Japan Society of Gynecologic Oncology (JSGO) guidelines for the treatment of vulvar cancer and vaginal cancer was published in 2015 in Japanese. OBJECTIVE: The JSGO committee decided to publish the English version of the JSGO guidelines worldwide, and hope it will be a useful guide to physicians in a similar situation as in Japan...
April 2018: International Journal of Clinical Oncology
Sasha Mikhael, Wesley Nilsson, Kruti Patel, Sherri Graf
Ectopic breast tissue is a rare condition caused by remnants of the mammary ridges that fail to involute during embryologic development. To date, only 39 cases have been reported in the literature worldwide. Here, we report the 40th case of a 69-year-old G3P2 postmenopausal Caucasian woman who presented with complaint of vulvar swelling. Biopsy of the mass revealed the presence of a benign mammary gland-like adenoma which was completely excised shortly thereafter. Clinical presentation of vulvar breast tissue is highly variable depending on the amount of breast tissue developed and its functionality...
2017: Case Reports in Obstetrics and Gynecology
Prashanth Hari Dass, Marion Jj Kuper-Hommel
BACKGROUND: Squamous cell vulvar cancers (SCVC) are rare. Although management guidelines have recently been published, New Zealand studies presenting "real world" outcomes are limited. METHODS: Retrospective single-centre review of SCVC diagnosed between 1 January 2000 and 31 August 2015. Clinical characteristics and outcomes were reviewed. RESULTS: Among 47 cases reviewed, 38 were ethnically European and 9 Māori. Cases identified as Stage 1 (16), Stage 2 (5), Stage 3 (17), Stage 4 (9)...
November 10, 2017: New Zealand Medical Journal
Kimberly L Levinson, David J Riedel, Laureen S Ojalvo, Wesley Chan, Ana M Angarita, Amanda N Fader, Anne F Rositch
OBJECTIVE: To evaluate gynecologic cancer treatments in HIV-infected women for adherence to National Comprehensive Cancer Network (NCCN) guidelines and to describe survival by adherence to guidelines. DESIGN: Beyond cervical cancer, there are little data on treatment and outcomes for these women. This is a retrospective cohort study of HIV-infected women with gynecologic cancers. METHODS: HIV-infected women with gynecologic cancers from 2000 to 2015 were identified at two urban, comprehensive cancer centers...
January 14, 2018: AIDS
Kelly Eileen Hughes, Christopher M McLaughlin, Emma C Fields
Vulvar cancer is a rare gynecological malignancy with incidence rates steadily increasing over the past 10 years. Despite aggressive treatment, recurrent disease is common. Vulvar cancer recurrence poses a significant therapeutic challenge as most patients have been previously treated with surgery and/or radiation limiting the options for additional treatment. There are no consensus guidelines for the treatment of recurrent disease. Current literature supports the use of salvage interstitial brachytherapy...
2017: Frontiers in Oncology
Roberta Granese, Gloria Calagna, Giuliana Morabito, Carmine Carriero, Antonio Perino, Gabriele Tonni, Claudio Romano
PURPOSE: The aim of the study is to report a systematic review (from 2000 to 2017) of all pediatric cases of vulvar Crohn's disease (VCD) and to highlight the key-points for a correct diagnosis and management of this rare condition. METHODS: An electronic search using the Pubmed/Medline, Scopus, EMBASE, Cochrane database and Google Scholar database was performed according to PRISMA guidelines. RESULTS: Twenty pediatric studies and 22 cases of VCD were included for analysis...
January 2018: Archives of Gynecology and Obstetrics
Ying Chen, Elizabeth Bruning, Joseph Rubino, Scott E Eder
Women use various feminine hygiene products, often as part of their daily cleansing routine; however, there is a paucity of published medical literature related to the external vulva and how personal hygiene practices can affect it. This review article provides background information on the physiological changes that occur during women's lives and reviews the relevance of transient and resident microbiota as they relate to common vaginal and vulvar disorders. It also discusses the need for female intimate hygiene, common practices of feminine hygiene from a global perspective, and the potential benefits of using suitable external, topical feminine vulvar washes to minimize the risk of vulvovaginal disorders and to improve overall intimate health in women around the world...
December 2017: Women's Health
A Borghi, A Virgili, S Minghetti, G Toni, M Corazza
BACKGROUND: According to the current guidelines, the aim of vulvar lichen sclerosus (VLS) treatment was to improve symptoms and signs, not to cure. OBJECTIVE: To assess (i) the rate of patients with VLS who achieved complete clearance of symptoms or objective features, or both, with a 12-week pharmacological treatment and (ii) the predictive value of therapeutic response to the demographic and clinical features. METHODS: We retrospectively included patients with VLS who had undergone any topical treatment for 12 weeks; demographics, history, VLS-related symptoms and objective features recorded at baseline and on completion of treatment were collected and elaborated...
January 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Rachel I Kornik, Alison S Rustagi
Vulvovaginal chronic graft-versus-host disease (cGVHD) is an underrecognized complication of stem cell transplantation. Early recognition may prevent severe sequelae. Genital involvement is associated with oral, ocular, and skin manifestations. Treatment includes topical immunosuppression, dilator use, and adjuvant topical estrogen. Clinical and histologic features may mimic other inflammatory vulvar conditions. In the right clinical context, these findings are diagnostic of chronic GVHD. Female recipients of allo-hematopoietic stem cell transplantation (HCT) are at higher risk of condylomas, cervical dysplasia, and neoplasia...
September 2017: Obstetrics and Gynecology Clinics of North America
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