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Skin infections
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
This common infection is due to a yeast pathogen (Candida albicans) that resides in the gastrointestinal tract as a commensal. It is a not infrequent cause of vulvovaginitis in pregnant women, in women taking oral contraceptives and in those taking broad-spectrum antibiotics for acne. It is also responsible for some cases of stomatitis in infants and the cause of infection of the gastrointestinal tract and elsewhere in immunosuppressed people. It may contribute to the clinical picture in the intertrigo seen in the body folds of the obese and in the napkin area in infancy. Treatment with the imidazole preparations, topical and systemic, is effective. Oral and vaginal moniliasis responds to preparations of nystatin and to the imidazoles. Severe Candida infections may be treated with systemic fluconazole.
Candida Vulvovaginitis
Published in William J. Ledger, Steven S. Witkin, Vulvovaginal Infections, 2017
William J. Ledger, Steven S. Witkin
Some physician intervention may not be appropriate for every patient. A diagnostic requirement for women with chronic vulvovaginitis repeated in every edition of gynecologic texts is that these women should be screened to see if they have unsuspected diabetes mellitus. The yield is so low in the population at large that this testing should be restricted to patients with risk factors for diabetes. With obesity becoming so prevalent in American and European youth with the concomitant increase in diabetes mellitus, more screening may become necessary in the future. Another popular therapeutic intervention in women with symptoms of chronic vulvovaginitis is the physician-applied local vaginal treatment with the dye gentian violet. There are potential problems with this approach: it is often used in women who do not have a Candida vulvovaginitis; it frequently does not work; and sometimes, women can have a severe reaction to the dye with excruciating vaginal burning that intensifies rather than relieves their symptoms. The most frequent mistake made in women with chronic or recurrent vulvovaginitis is to attempt to make a diagnosis and treat the patient at the first clinical contact. There is no dishonor in holding off therapy when in doubt, until all culture results are available. This avoids mislabeling the patient’s problem and utilizing treatment interventions that will not help and at times will worsen the problem.
Female-specific pruritus
Published in Miranda A. Farage, Howard I. Maibach, The Vulva, 2017
Michael Joseph Lavery, Carolyn Stull, Shoshana Korman Grossman, Gil Yosipovitch
Non-bacterial causes of infective vulvovaginitis include scabies, public lice, and pinworm infestations, and are summarized in Table 20.3 (7–11). Patients suffering from these conditions often report intense pruritus and may also present with an eczematous rash.
Efficacy of intradermal hyaluronic acid plus polynucleotides in vulvovaginal atrophy: a pilot study
Published in Climacteric, 2022
M. Angelucci, F. Frascani, A. Franceschelli, A. Lusi, M. L. Garo
The questionnaires for each patient were reported in a Microsoft Excel file (Microsoft Corp., Redmond, WA, USA). Statistical analyses were performed using STATA16 (StataCorp., College Station, TX, USA). Quantitative data were presented as the mean ± standard deviation (minimum–maximum) or the median and interquartile range (IQR) for variables with non-normal distribution. Qualitative data were reported as the count and percentage of the total. Quantitative data were first tested for normality with the Shapiro–Wilk test. Patient-specific VHI and VuHI scores and pH were assessed at T0, T1 and T2. FSFI was assessed at T0 and T2. VHI lower than 15 and VuHI higher than 8 were used to assess atrophic vulvovaginitis. The Wilcoxon matched-paired signed-rank test was performed to estimate statistically significant differences among the median scores across the time points. Statistical significance was set at 5% (p < 0.05).
Females with impaired ovarian function could be vulnerable to environmental pollutants: identification via next-generation sequencing of the vaginal microbiome
Published in Journal of Obstetrics and Gynaecology, 2022
Seongmin Kim, Se Hee Lee, Kyung Jin Min, Sanghoon Lee, Jin Hwa Hong, Jae Yun Song, Jae Kwan Lee, Nak Woo Lee, Eunil Lee
There are a few limitations to this study. First, we were not able to obtain any information about the presence of vaginitis or any other underlying disease. The existence of vaginitis or vaginal atrophy could be related to the differences observed in the vaginal microbiome (Hong et al. 2016). However, we retrospectively reviewed the medical records of all participants, and identified only three women with suspected vulvovaginitis on physical examination (two in the normal group and one in the IO group). This low incidence should not have caused a difference in the entire study population. Second, the number of patients with POI in this study was small, as most of the participants in the IO group were still menstruating and had some reproductive function, although their AMH levels were low. Therefore, additional investigations including more patients with POI are necessary to definitively determine the influence of pollutants on the vaginal microbiome between women with normal ovarian function and patients with POI.
Anidulafungin treatment for fluconazole-resistant Candida albicans vaginitis with cross-resistance to azoles: a case report
Published in Journal of Obstetrics and Gynaecology, 2021
Damla Akdağ, Hüsnü Pullukçu, Tansu Yamazhan, Dilek Yeşim Metin, Oğuz Reşat Sipahi, Beyza Ener, Meltem Işıkgöz Taşbakan
Vulvovaginal candidiasis negatively affects the daily life of patients and their sexual partners. Most acute attacks are treated empirically by the patients themselves or by physicians. Fluconazole—containing topical treatments (ovules, creams, etc.) and the systemic drugs—are being used often for this purpose. An oral single dose of 150 mg fluconazole or 100 mg oral itraconazole twice a day are the main treatment options for the treatment of acute vulvovaginal candidiasis. There are also topical treatment options including amphotericin B, nystatin, miconazole, clotrimazole or flucytosine (van Schalkwyk et al. 2015; Workowski and Bolan 2015). A prolonged, 7−30 days of treatment may be required, especially for recurrent candidiasis. There are also publications indicating that boric acid-containing capsules may be useful for non-albicans strains (Sobel and Sobel 2018; Felix et al. 2019). Despite all of these regimens, recurrent vulvovaginitis may still be a common problem for women.