Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 23
Filter
1.
Einstein (Sao Paulo) ; 20: eRC6541, 2022.
Article in English | MEDLINE | ID: mdl-35137798

ABSTRACT

Acute vulvar ulcer (Lipschütz's ulcer) is a rare lesion with local hyperimmunoreactivity triggered by infection, which is characterized by acute, painful, and necrotic ulcerations. This condition is usually found in non-sexually active adolescents, and it resolves spontaneously. We report a case of a 35-year-old woman who was diagnosed with COVID-19 who did not have severe symptoms, but had high levels of D-dimer for 9 days. The COVID-19 diagnosis was followed by the appearance of an acute, necrotic, extremely painful vulvar ulcer, although symptoms caused by COVID-19 had improved. We emphasize the importance of the differential diagnosis to exclude diseases such as Behçet's syndrome, Sexually Transmitted Infections, as well as the presence of viruses that generally trigger Lipschütz's ulcer, such as Epstein-Barr virus and cytomegalovirus. No treatment is usually necessary, however, in the present report due to the pain experienced by the patient, we successfully used oral prednisone.


Subject(s)
Behcet Syndrome , COVID-19 , Epstein-Barr Virus Infections , Adolescent , Adult , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , COVID-19 Testing , Female , Genitalia , Herpesvirus 4, Human , Humans , SARS-CoV-2 , Ulcer/drug therapy
2.
Einstein (Säo Paulo) ; 20: eRC6541, 2022. graf
Article in English | LILACS | ID: biblio-1360395

ABSTRACT

ABSTRACT Acute vulvar ulcer (Lipschütz's ulcer) is a rare lesion with local hyperimmunoreactivity triggered by infection, which is characterized by acute, painful, and necrotic ulcerations. This condition is usually found in non-sexually active adolescents, and it resolves spontaneously. We report a case of a 35-year-old woman who was diagnosed with COVID-19 who did not have severe symptoms, but had high levels of D-dimer for 9 days. The COVID-19 diagnosis was followed by the appearance of an acute, necrotic, extremely painful vulvar ulcer, although symptoms caused by COVID-19 had improved. We emphasize the importance of the differential diagnosis to exclude diseases such as Behçet's syndrome, Sexually Transmitted Infections, as well as the presence of viruses that generally trigger Lipschütz's ulcer, such as Epstein-Barr virus and cytomegalovirus. No treatment is usually necessary, however, in the present report due to the pain experienced by the patient, we successfully used oral prednisone.


Subject(s)
Humans , Female , Adolescent , Adult , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , Epstein-Barr Virus Infections , COVID-19 , Ulcer/drug therapy , Herpesvirus 4, Human , COVID-19 Testing , SARS-CoV-2 , Genitalia
6.
Braz J Infect Dis ; 20(3): 294-7, 2016.
Article in English | MEDLINE | ID: mdl-27037113

ABSTRACT

The purpose of this study was to assess the risk of abnormal anal cytology in women with known genital squamous intraepithelial lesion. This study evaluated 200 women with and without genital squamous intraepithelial lesion who were recruited for anal Pap smears. Women who had abnormal results on equally or over atypical squamous cells of undetermined significance were classified as having abnormal anal cytology. A multiple logistic regression analysis (stepwise) was performed to identify the risk for developing abnormal anal cytology. Data were analyzed using the SPSS 20.0 program. The average age was 41.09 (±12.64). Of the total participants, 75.5% did not practice anal sex, 91% did not have HPV-infected partners, 92% did not have any anal pathology, and 68.5% did not have anal bleeding. More than half (57.5%) had genital SIL and a significant number developed abnormal anal cytology: 13% in the total sample and 17.4% in women with genital SIL. A significant association was observed between genital squamous intraepithelial lesion and anal squamous intraepithelial lesion (PR=2.46; p=0.03). In the logistic regression model, women having genital intraepithelial lesion were more likely to have abnormal anal Pap smear (aPR=2.81; p=0.02). This report shows that women with genital squamous intraepithelial lesion must be more closely screened for anal cancer.


Subject(s)
Anal Canal/pathology , Squamous Intraepithelial Lesions of the Cervix/pathology , Adult , Anal Canal/virology , Case-Control Studies , Female , Humans , Papanicolaou Test , Papillomaviridae/isolation & purification , Papillomavirus Infections/pathology , Papillomavirus Infections/virology , Risk Factors , Sexual Behavior , Squamous Intraepithelial Lesions of the Cervix/virology , Uterine Cervical Neoplasms/pathology
7.
Diagn Cytopathol ; 43(5): 360-5, 2015 May.
Article in English | MEDLINE | ID: mdl-25421882

ABSTRACT

BACKGROUND: Screening for anal cancer using cytology has not been considered in immunocompetent women. The aim of this study was to identify cytological atypia and human papillomavirus (HPV) DNA in intra-anal specimens from human immunodeficiency virus (HIV)-negative women with and without genital HPV lesions. METHODS: This study was a cross-sectional analysis of 142 women who were negative for the HIV: 80 with genital lesions that were associated with HPV and 62 without HPV-induced lesions. The women were evaluated at the Federal University of Ceará from October 2011 to June 2012. The statistical analysis included the Fisher exact test and the odds ratio (CI 95%). RESULTS: Atypical anal cytology was observed in 24 (29.3%) patients in the study group and in 11 (17.8%) patients in the control group. In cases with at least two sites of HPV-associated lesions, 12 (41.4%) presented atypical cytology (P = 0.0220; OR = 2.7621, 1.1579-6.5889). When the practice of anal sex was evaluated, atypical cytology was observed in 22/43 (34%) [P = 0.0214; OR = 2.519, 1.146-5.534]. HPV DNA was detected in 17/27 (63%) cases with at least two sites of lesions (P = 0.0293, OR = 2.4855, 1.0960-5.6367). In the 33 cases who presented positive HPV DNA test results, the liquid-based cytology results were atypical (P = 0.0212, OR = 2.8, 1.1665-6.7208). CONCLUSION: Based on the results, liquid-based cytology may be used to detect intra-anal lesions, especially among women who have a history of anal intercourse or who have genital HPV-associated lesions at multiple sites.


Subject(s)
Anal Canal/pathology , Anus Neoplasms/diagnosis , Atypical Squamous Cells of the Cervix/pathology , DNA, Viral/isolation & purification , Papillomavirus Infections/diagnosis , Squamous Intraepithelial Lesions of the Cervix/pathology , Adult , Anal Canal/virology , Anus Neoplasms/pathology , Anus Neoplasms/virology , Atypical Squamous Cells of the Cervix/virology , Case-Control Studies , Cross-Sectional Studies , Cytodiagnosis/methods , Female , HIV Infections , Histocytochemistry/methods , Human Papillomavirus DNA Tests , Humans , Middle Aged , Papillomaviridae/pathogenicity , Papillomaviridae/physiology , Papillomavirus Infections/pathology , Papillomavirus Infections/virology , Sexual Behavior/statistics & numerical data , Squamous Intraepithelial Lesions of the Cervix/virology
8.
Am J Obstet Gynecol ; 205(2): 115.e1-5, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21684518

ABSTRACT

OBJECTIVE: The objective of the study was to evaluate the risk of anal squamous intraepithelial lesions (ASILs) in immunocompetent women with genital squamous intraepithelial lesions (GSILs). STUDY DESIGN: This was a cross-sectional study that included 260 immunocompetent women divided into 2 study groups: 1 group included 184 women diagnosed with GSIL by genital colposcopy and biopsy, and the other included 76 controls. All subjects were submitted to anoscopy followed by a biopsy if pertinent. RESULTS: Of 184 GSIL women, 32 (17.4%) had ASIL (P<.001). The risk of ASIL was 13.1 times greater for GSIL women when there were 3 or 4 genital sites involved. All cases of high-grade ASIL were found in women with cervical GSILs. Among risk factors, anal intercourse without a condom demonstrated an important association with ASIL (prevalence ratio adjusted for age=2.6). CONCLUSION: There seems to be a strong association between ASIL and multicentric GSIL. Another factor related to ASIL was the practice of unprotected anal intercourse.


Subject(s)
Anus Neoplasms/epidemiology , Carcinoma in Situ/epidemiology , Carcinoma, Squamous Cell/surgery , Genital Neoplasms, Female/epidemiology , HIV Seronegativity , Adolescent , Adult , Age Distribution , Anus Neoplasms/pathology , Biopsy, Needle , Brazil/epidemiology , Carcinoma in Situ/pathology , Carcinoma, Squamous Cell/pathology , Colposcopy/methods , Comorbidity , Confidence Intervals , Cross-Sectional Studies , Female , Follow-Up Studies , Genital Neoplasms, Female/pathology , Humans , Immunocompetence , Incidence , Logistic Models , Middle Aged , Multivariate Analysis , Neoplasm Invasiveness/pathology , Neoplasm Staging , Proctoscopy/methods , Risk Assessment , Sexual Behavior , Socioeconomic Factors , Young Adult
9.
DST j. bras. doenças sex. transm ; 23(2): 66-68, 2011. tab
Article in Portuguese | LILACS | ID: lil-611887

ABSTRACT

Introdução: o papilomavírus humano (HPV) é um vírus bastante prevalente no mundo. Atualmente existem em torno de 200 tipos identificados, e destes,aproximadamente 45 acometem a área anogenital. Embora se saiba da alta prevalência de infecções pelo HPV entre adolescentes com atividade sexual,poucos estudos têm conseguido demonstrar a presença do vírus entre meninas antes da coitarca. Objetivo: determinar a prevalência de papilomavírus humano (HPV) em adolescentes e mulheres jovens sem coitarca. Métodos: foram avaliadas 50 mulheres adolescentes atendidas no ambulatório deginecologia infanto-puberal do Hospital Universitário Pedro Ernesto (HUPE) da Universidade do Estado do Rio de Janeiro com idade até 20 anos, que relatavam não ter tido coitarca e apresentavam hímen íntegro no exame físico feito por ginecologista de larga experiência, entre janeiro de 2007 a janeiro de 2009. Foi realizada coleta em região de vestíbulo vulvar e o material foi encaminhado ao laboratório de biologia molecular para detecção de DNA HPV por método de captura híbrida de 2a geração (hC2). Resultados: nas 50 pacientes testadas para DNA-HPV a idade variou de 11 a 20 anos completos(média: 15,88 + 2,04) e todas negavam coito e apresentavam hímen íntegro. O teste de DNA-HPV por hC2 foi positivo em três casos (6%). Em dois casos foi detectado HPV de não alto risco e em um caso, HPV de alto risco. Após seis meses, um segundo teste de DNA-HPV foi negativo em duas das três pacientes. A terceira não foi testada. Conclusão: a infecção pelo HPV pode ocorrer antes da coitarca e mesmo nas situações em que não há contato genital.


Introduction: the human papillomavirus (HPV) virus is an extremely prevalent in the world. Currently there are around 200 types identified, about 45 of which affect the anogenital area. Although the high prevalence of HPV infection among sexually active adolescents is known, few studies have succeeded in demonstrating the presence of the virus among girls before sexual intercourse. Objective: to assess the prevalence of human papillomavirus (HPV) inadolescents and young women prior to coitarche assisted at an out patient gynecological unit. Methods: this study included 50 adolescents assisted at the gynecology unit in University Hospital Pedro Ernesto (HUPE), State University of Rio de Janeiro. The patients were below 20 years old, who reported no sexual intercourse and with intact hymen on physical examination by a gynecologist with broad experience, from January 2007 to January 2009. The material for study was collected from vulvar vestibule for detection of HPV-DNA by Hybrid Capture second generation (hC2). Results: in the 50 patientstested for HPV-DNA age ranged from 11 to 20 years old (mean: 15.88 + 2.04) and all of them denied coitus and had intact hymen. The hC2 was positive inthree cases (6%). In two cases non-high risk HPV was detected and in one case high-risk HPV was identified. After 6 months, a second test for HPV-DNA was negative in two out of three patients. The third one was not tested. Conclusion: HPV infection can occur before the first sexual intercourse and evenin situations where there is no genital contact.


Subject(s)
Humans , Female , Adolescent , Sexually Transmitted Diseases , Adolescent , Papillomavirus Infections/diagnosis , DNA Probes , Hospitals, University , Molecular Biology/methods
10.
Eur J Obstet Gynecol Reprod Biol ; 142(1): 73-5, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19019529

ABSTRACT

OBJECTIVE: To determine the frequency of anal squamous intra-epithelial lesions (ASIL) in women with genital squamous intra-epithelial lesions (GSIL). STUDY DESIGN: In a cross sectional study, 184 patients with histopathological diagnosis of GSIL and 76 controls without GSIL, were submitted to anuscopy in order to determine the presence of ASIL. All the women were HIV-negative with anal aceto-white lesions were biopsed for histological diagnosis. RESULTS: The frequency of ASIL was 17.4% in the GSIL group (3.2% high grade ASIL) and only 2.6% in the control group (0% high grade ASIL) (p<0.001). All the high grade ASIL diagnoses were found in women with cervical SIL. CONCLUSION: Women presenting GSIL have high prevalence of ASIL.


Subject(s)
Anus Diseases/epidemiology , Adult , Cross-Sectional Studies , Female , Humans , Muscular Diseases/epidemiology , Uterine Cervical Dysplasia/epidemiology
11.
Femina ; 35(9): 545-549, set. 2007. tab
Article in Portuguese | LILACS | ID: lil-493964

ABSTRACT

O estudo de patologias na vulva envolve a necessidade de conhecimentos não só em Ginecologia, como também em patologia e dermatologia, o que pode trazer dificuldades para o ginecologista geral na condução do diagnóstico e, conseqüentemente, do tratamento. Assim, a vulva acaba por ser uma região esquecida. Há necessidade de diretrizes que facilitem a avaliação da área vulvar de forma acessível, porém não esquecendo da necessidade de uma abordagem multidisciplinar. Os autores fazem uma revisão da literatura e propõem um fluxograma com o qual o examinador possa direcionar sua conduta no estudo das patologias da vulva, englobando as de origem ginecológica e não ginecológica, com especial ênfase nas neoplasias intra-epiteliais vulvares.


Subject(s)
Female , Uterine Cervical Dysplasia , Papillomavirus Infections/diagnosis , Medical History Taking , Vulvar Neoplasms/diagnosis , Vulvar Neoplasms/therapy , Skin Diseases , Vulva/pathology , Diagnosis, Differential
12.
Eur J Obstet Gynecol Reprod Biol ; 124(2): 227-31, 2006 Feb 01.
Article in English | MEDLINE | ID: mdl-16143445

ABSTRACT

UNLABELLED: Secretory IgA contributes towards the protection of mucosal surfaces against invading microorganisms. OBJECTIVES: Quantify secretory IgA titers in the saliva of women with HPV in the oropharynx and/or in the genital area. SUBJECTS AND METHODS: Seventy women with clinical genital HPV lesions and 70 women without HPV infection were tested for oral HPV DNA and the levels of total IgA in their saliva. One millilitre of saliva was collected, centrifuged and stored at -80 degrees C for the measurement of secretory IgA by nephelometry technique. A pool of oral pharyngeal cells was collected for HPV identification by polymerase chain reaction. RESULTS: Oral HPV PCR was positive in 29 (21%) women (26 women with genital HPV and only 3 women without genital HPV). Titers of secretory IgA were extremely lower in-patients with HPV DNA in the oropharynx when compared to HPV negative women (p<0.0001). Genital HPV and smoking were also associated to low levels of total sIgA in saliva (p<0.01). After multivariable analyses only the presence of HPV in the oral cavity and/or in genital area, but not smoking, was related to low levels of total secretory IgA. CONCLUSION: Women with low levels of total secretory IgA could be more susceptible to having their oral mucosa colonized by HPV.


Subject(s)
Genitalia, Female/virology , Immunoglobulin A, Secretory/isolation & purification , Mouth/virology , Papillomavirus Infections/immunology , Saliva/immunology , Adult , DNA, Viral/analysis , Female , Humans , Mouth Mucosa , Papillomaviridae/genetics , Papillomaviridae/immunology , Papillomavirus Infections/diagnosis , Polymerase Chain Reaction , Prognosis
15.
DST j. bras. doenças sex. transm ; 17(2): 149-152, 2005.
Article in Portuguese | LILACS | ID: lil-426890

ABSTRACT

A vaginose bacteriana, doença frequente acomete a gestante brasileira em aproximadamente 20 por cento dos casos e parece estar associada ao trabalho de parto prematuro, rotura prematura de membranas e baixo peso peso do recém-nascido


Subject(s)
Adult , Female , Humans , Obstetric Labor, Premature , Pregnancy Complications , Vaginosis, Bacterial , Vulvovaginitis
SELECTION OF CITATIONS
SEARCH DETAIL
...