Presentation
The 7 women all presented with 1 or more painful, punched-out vulvar ulcers. [ncbi.nlm.nih.gov]
The cause is mostly infectious, but it may otherwise be a presentation of a wide variety of pathologies, such as autoimmune (eg, Behçet’s disease), cancer or inflammatory processes. The Lipschütz ulcer is a non-sexually transmitted condition. [casereports.bmj.com]
Entire Body System
- Malaise
Only patients with acute EBV infection showed other clinical findings: fever and/or atypical lymphocytosis affected 75% (3/4); lymphadenopathy in 50%; and malaise/fatigue, dysuria and/or hepatomegaly in 25%. [ncbi.nlm.nih.gov]
Nineteen of the subjects reported fever, malaise, and headache. The ulcers were found to be about 1cm in diameter (with the range being from 0.3 to 5cm), all on the inside of the labia minora (medial side). [allthingsvagina.com]
This second stage may be associated with fever, malaise, and flu-like symptoms. Later in the disease, perirectal involvement may lead to severe scarring, strictures, and rectal-vaginal fistulas. [encognitive.com]
A review of systems should include: Systemic symptoms (fever, malaise, headache, GI symptoms, respiratory symptoms, myalgia) Oral ulcers, skin lesions, ocular symptoms. A family history of autoimmune disorders should be determined. [rch.org.au]
The ulcer develops very quickly, and is usually preceded by sudden onset of fever and malaise. [11] Diagnosis [ edit ] The diagnosis is mainly clinical and centred in eliminating other more common causes for vulvar ulcers. [en.wikipedia.org]
- Gangrene
Periadenitis mucosa necrotica recurrens Recurrent aphthous ulcer Stomatitis herpetiformis genital organ (s) female N76.6 Disease, diseased - see also Syndrome Lipschütz's N76.6 Lipschütz disease or ulcer N76.6 Phagedena (dry) (moist) (sloughing) - see also Gangrene [icd10data.com]
Pyoderma gangrenosum Bacterial and mycobacterial infections, tropical ulcers, tertiary syphilis, chronic ulcerative HSV infection, deep mycoses, ecthyma gangrenosum, and postoperative progressive gangrene are excluded based on history findings, clinical [emedicine.medscape.com]
- Weakness
[…] regular involvement in outdoor sports or activities Regular use of tanning beds or tanning parlors Individuals residing in geographical regions where hot, dry, desert-like climatic conditions exist Muir-Torre syndrome (a genetic disorder) Individuals with weak [dovemed.com]
Respiratoric
- Cough
[…] irritants Symptoms & Types Symptoms may include: Groups of blisters or red spots on the genitals or buttocks A single deep painful ulcer Sores that bleed easily on contact Flu-like symptoms, including fever, headache, sore throat, vomiting, diarrhea, coughing [texaschildrens.org]
Case presentation A 10-year-old non-sexually active girl of cypriot origin presented at a hospital with fever, dry cough, and acute vulvar ulcers. [link.springer.com]
Jaw & Teeth
- Aphthous Stomatitis
ulcerating, ulceration, ulcerative aphthous (oral) (recurrent) K12.0 ICD-10-CM Diagnosis Code K12.0 Recurrent oral aphthae 2016 2017 2018 2019 Billable/Specific Code Applicable To Aphthous stomatitis (major) (minor) Bednar's aphthae Periadenitis mucosa [icd10data.com]
Aphthous ulcers Also known as apthae, recurrent aphthous stomatitis (RAS), recurrent oral aphthae, Mikulicz ulcers, Sutton’s ulcer, periadenitis mucosa necrotica recurrens (PMNR), canker sores, simple or complex aphthosis, non-sexually acquired genital [dermcoll.edu.au]
Skin
- Blister
Sores, blisters, or lumps in the vaginal area Conditions that may cause a sore, blister, or lump include: Genital herpes. Genital herpes is a viral infection that causes skin blisters and sores in the vaginal area. Genital warts. [northshore.org]
Following this, they may scab and heal The sores of HSV are initially multiple, small blisters, which then burst to form an ulcer. [dovemed.com]
Blistering diseases Autoimmune blistering diseases may present with erosions and ulcers. The vulva is rarely the only site affected. Pemphigus vulgaris is a non-scarring erosive disease. [dermnetnz.org]
- Acne Vulgaris
vulgaris and acne mechanica—from acute and chronic follicular occlusion. [emedicine.medscape.com]
Musculoskeletal
- Myalgia
A review of systems should include: Systemic symptoms (fever, malaise, headache, GI symptoms, respiratory symptoms, myalgia) Oral ulcers, skin lesions, ocular symptoms. A family history of autoimmune disorders should be determined. [rch.org.au]
Systemic symptoms and signs such as fever, malaise, headache, gastrointestinal distress, pharyngitis, and myalgia occur in many of these young women with complex aphthosis but these are usually mild, time-limited, and nondebilitating 1. [plasticsurgerykey.com]
Neurologic
- Headache
Nineteen of the subjects reported fever, malaise, and headache. The ulcers were found to be about 1cm in diameter (with the range being from 0.3 to 5cm), all on the inside of the labia minora (medial side). [allthingsvagina.com]
[…] procedures such as maggot treatment for chronic ulcers, endovenous vein closure, stress echo, insertion of the contraceptive capsule (Implanon) and tubal implant (Essure), musculoskeletal ultrasound, no-needle/no-scalpel vasectomy, procedures to treat acute headaches [books.google.com]
[…] sclerosis, contact dermatitis or hair removal irritants Symptoms & Types Symptoms may include: Groups of blisters or red spots on the genitals or buttocks A single deep painful ulcer Sores that bleed easily on contact Flu-like symptoms, including fever, headache [texaschildrens.org]
A review of systems should include: Systemic symptoms (fever, malaise, headache, GI symptoms, respiratory symptoms, myalgia) Oral ulcers, skin lesions, ocular symptoms. A family history of autoimmune disorders should be determined. [rch.org.au]
[…] with plasma cells, endarteritis within or outside capsule, fibrosis (capsular, pericapsular), follicular hyperplasia Secondary syphilis Usually rash on palms and soles that doesn't itch, which appears 2 - 10 weeks after chancre Other symptoms include headache [pathologyoutlines.com]
Urogenital
- Dysuria
Only patients with acute EBV infection showed other clinical findings: fever and/or atypical lymphocytosis affected 75% (3/4); lymphadenopathy in 50%; and malaise/fatigue, dysuria and/or hepatomegaly in 25%. [ncbi.nlm.nih.gov]
[…] carcinoma typically presents as a unifocal plaque, ulcer, or mass on the labia majora 1 and is most common in postmenopausal white women. 1, 2 Patients often report a pruritic area that becomes a red, nonhealing wound. 1 Vulvar bleeding, discharge, dysuria [aafp.org]
[…] features May initially be asymptomatic Local pruritus, possibly with burning sensation and pain Reddish, blackish, and/or whitish patches of discoloration Lumps or growths of various shapes, often wart-like lesions or ulcers Vulvar bleeding or discharge Dysuria [amboss.com]
Spray bottles or voiding in the bath to reduce external dysuria Petrolatum or zinc oxide barrier after soak Topical anaesthetics (ie. [rch.org.au]
The ulcers may be very painful and result in dysuria (pain passing urine) or prevent urination altogether ( acute retention of urine) requiring admission to hospital and catheterisation. Local lymph nodes may be enlarged and tender. [dermnetnz.org]
- Vulvar Pain
Chronic pain of the vulva Conditions include: vulvodynia – this is vulvar pain of at least three months’ duration without an obvious cause found. It is not an inflammation or infection vestibular pain is now called vestibulodynia. [betterhealth.vic.gov.au]
All 3 presented with extensive, painful, and destructive vulvar ulcers. [ncbi.nlm.nih.gov]
The child developed a sore throat and low-grade fever 3 days earlier, with vulvar pain and vulvar dysuria the next day. [mdedge.com]
Workup
Extensive dermatologic workup and serial skin biopsies failed to reveal an underlying vulvar dermatosis or autoimmune bullous disorder. Virologic studies revealed resistance to acyclovir in vitro due to deficiency in thymidine kinase activity. [ncbi.nlm.nih.gov]
Results of a full workup for STIs were negative, including negative immunoglobulin G and M results for herpes simplex virus (HSV). The wound culture results were normal. Test results for Epstein-Barr virus (EBV) were negative. [consultant360.com]
Differential Diagnosis and Workup Workup and procedures If the diagnosis is not readily apparent, unaided (ie, naked-eye) or colposcopic examination of the vulva may define areas of abnormality that may warrant biopsy using a Keyes punch or biopsy forceps [emedicine.medscape.com]
Laboratory
- Leukocytosis
[…] for some of the well differentiated, keratinizing and warty forms of SCC, most vulvar tumors look clinically similar to each other Histopathologic examination is essential for diagnosis Laboratory Except for nonspecific findings such as anemia, mild leukocytosis [pathologyoutlines.com]
Treatment
الصفحة 34 - A proposed glossary of terminology related to the surgical treatment of vulvar carcinoma. Cancer 83: 13691375, 1998. [books.google.com]
Ginsburg PM, Dassopoulos T, Ehrenpreis ED: Thalidomide treatment for refractory Crohn’s disease: A review of the history, pharmacological mechanisms and clinical literature. Ann Med 2001;33:516–525. [karger.com]
She was admitted for study and treatment, starting empiric treatment with doxycycline, acyclovir and analgesia (local and intravenous). [casereports.bmj.com]
After Treatment Get information about life as a cancer survivor, next steps, and what you can do to help. [cancer.org]
Prognosis
(Outcomes/Resolutions) The prognosis of Keratoacanthoma of Vulva is excellent after complete excision of the tumor The prognosis may be dependent upon the underlying condition and health status of the individual Despite treatment, these tumors can occasionally [dovemed.com]
Vulvar cancer is usually associated with a poor prognosis. [amboss.com]
The prognosis for women with idiopathic (primary) complex aphthosis involving the vulva is unclear. [plasticsurgerykey.com]
Each of the treatments may be used alone or in combination, depending on the stage of the lesion. 1, 3 The prognosis is determined by the size of the lesion, lymph node involvement, and presence or absence of distant metastasis. [aafp.org]
Etiology
By considering other etiologies, the patient will be spared potentially embarrassing persistent questioning about her sexual history. [ncbi.nlm.nih.gov]
Vaginal cancer is closely related to vulvar cancer in terms of etiology and histology, but it occurs inside the vagina (typically the posterior third of the vaginal wall), rather than the vulva. [amboss.com]
Epidemiology
Genital Ulcer Disease Management Herpes Simplex Management • Treat for syphilis, and, depending upon local epidemiology, either chancroid, granuloma inguinale or lymphogranuloma venereum • Aspirate any fluctuant glands (surgical incision should be avoided [apps.who.int]
This report defines the prevalence of genital colonization in a large population of women, characterizes the women with S. aureus, and describes epidemiologic features of genital carriage. Pagina 50 - Lautenschlager S, Eichmann A. [books.google.it]
[…] architecture Lichen simplex chronicus : squamous cell hyperplasia Other dermatoses, e.g., genital lichen planus ( hypertrophied skin with purple lesions) Etiology : unclear (hormonal, immunological, and/or infectious factors are believed to play a role) Epidemiology [amboss.com]
[…] arising from the epithelial components of the vulva Since most of the common malignancies affecting the vulva are discussed separately, this section will focus on General aspects of vulvar carcinomas Rare, unusual type of carcinomas that affect the vulva Epidemiology [pathologyoutlines.com]
Epidemiology [ edit ] The disorder typically appears among young girls and adolescents but cases in children as young as 17 months have been reported. [7] History [ edit ] The disease was first described in October 1912 by Galician -born Austrian dermatologist [en.wikipedia.org]
Pathophysiology
The pathophysiologic features involve blockage of the gland duct, with continued secretion or infection of the gland itself. Without a route of egress, the glandular location swells and enlarges (Fig. 17). [glowm.com]
Etiology and Pathophysiology Nonneoplastic epithelial disorders are discussed below. [emedicine.medscape.com]
Prevention
الصفحة 104 - A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. الصفحة 104 - Lafferty WE, Downey L, Celum C, Wald A. Herpes simplex virus type 1 as a cause of genital herpes: impact on surveillance and prevention. [books.google.com]
C 15, 16 Prevention Avoiding sexual intercourse during outbreaks does not prevent transmission of HSV infection. [aafp.org]
Causes, Risk Factors, and Prevention Learn about the risk factors for vulvar cancer and what you might be able to do to help lower your risk. Early Detection, Diagnosis, and Staging Know the signs and symptoms of vulvar cancer. [cancer.org]