scholarly journals Management of Lichen Sclerosus and Intraepithelial Neoplasia of the Vulva in the UK

1996 ◽  
Vol 89 (12) ◽  
pp. 699-701 ◽  
Author(s):  
J A Tidy ◽  
W P Soutter ◽  
D M Luesley ◽  
A B MacLean ◽  
C H Buckley ◽  
...  
Keyword(s):  
Paget’S Disease ◽  
Lichen Sclerosus ◽  
Great Majority ◽  
Intraepithelial Neoplasia ◽  
Postal Questionnaire ◽  
Paget's Disease ◽  
Treatment Modalities ◽  
Topical Steroids ◽  
Senior Registrar ◽  
The Uk

Women with vulval intraepithelial neoplasia (VIN), lichen sclerosus (LS) and Paget's disease are referred either to gynaecologists or to dermatologists. We have ascertained the caseloads, referral patterns and treatment modalities used in the two specialties. A postal questionnaire was sent to 540 consultant gynaecologists and 225 consultant and senior registrar members of the British Association of Dermatologists. 350 gynaecologists and 161 dermatologists returned completed questionnaires. The workload of LS and Paget's disease was evenly distributed, with 54% of dermatologists and 58% of gynaecologists seeing more than six cases of LS per annum and less than 1% seeing more than five cases of Paget's disease. 92% of responding gynaecologists saw at least one case of VIN per year whereas 43% of dermatologists saw no cases. Patients with VIN and Paget's were referred to gynaecologists for treatment by 66% of dermatologists. Both groups are equally prepared to treat LS. Indications for treatment of VIN and LS were suspicion of invasion and symptoms. Local excision of VIN is the treatment of choice by both gynaecologists and dermatologists. LS is predominantly treated with topical steroids but gynaecologists also use topical oestrogen and testosterone. The great majority of responders favoured establishing a national register to study the outcome of vulval lesions.

Premalignant and malignant disease of the vulva and vagina

2020 ◽  
pp. 797-808
Author(s):  
Linda Rogers ◽  
Maaike Oonk ◽  
Ate van der Zee
Keyword(s):  
Cancer Treatment ◽  
Vulvar Cancer ◽  
Elderly Women ◽  
Survival Rates ◽  
Paget’S Disease ◽  
Intraepithelial Neoplasia ◽  
Paget's Disease ◽  
Vaginal Cancer ◽  
Sentinel Node Procedure ◽  
Vulval Intraepithelial Neoplasia

Vaginal intraepithelial neoplasia is a rare, premalignant condition of the vagina, which is caused by persistent infection with oncogenic strains of the human papillomavirus (HPV). It occurs either concurrently with intraepithelial neoplasia of other parts of the anogenital tract, or can develop after treatment of cervical lesions or pelvic irradiation. It can be difficult to diagnose and treat, due to the proximity of surrounding structures such as the bladder and rectum, and the need to preserve sexual function. Squamous carcinoma of the vulva is the most common vulval malignancy. It may arise from two distinct types of vulval intraepithelial neoplasia (VIN). Vulval extramammary Paget’s disease is a rare intraepithelial adenocarcinoma which accounts for less than 2% of primary vulval tumours. VIN and Paget’s disease are treated in order to relieve symptoms, such as severe pruritus, to exclude invasive disease, and to decrease the risk of developing cancer. Specialist follow-up in multidisciplinary clinics, with access to conservative surgery and reconstruction, as well as psychosexual support, are important in the management of women with vulval premalignant disease. Vulvar and vaginal cancer are rare gynaecological malignancies that occur predominantly in elderly women. Where the cornerstone of vulvar cancer treatment is surgery, radiotherapy is the most common treatment given in vaginal cancer. Vulvar cancer treatment has undergone significant modifications during the last decades, all with the aim to reduce treatment-related morbidity without compromising survival rates. The introduction of the sentinel node procedure has been a major advantage in the treatment of this disease.

scholarly journals DIAGNOSIS AND MANAGEMENT OF PAGET'S DISEASE OF BONE - SERIES OF 8 CASES

2019 ◽  
Vol 27 (1) ◽  
pp. 31-32
Author(s):  
Felipe Augusto Kazan de Oliveira ◽  
Fábio Fernando Eloi Pinto ◽  
Trajano Sardenberg ◽  
Gilberto José Cação Pereira ◽  
Emílio Carlos Curcelli ◽  
...  
Keyword(s):  
Paget’S Disease ◽  
Case Series ◽  
Paget's Disease ◽  
Bone Diseases ◽  
Paget’S Disease Of Bone ◽  
Paget's Disease Of Bone ◽  
Level Of Evidence ◽  
Hereditary Component ◽  
The Uk ◽  
Study Type

ABSTRACT Paget's disease of bone is a chronic condition characterized by focal abnormalities of absorption and formation of bone, and it may lead to anatomical deformities, pain, fractures, and malignant transformation. It is common in the UK, Australia, New Zealand, and North America and has a strong hereditary component, affecting first- to third-degree relatives. The etiology remains unclear and treatment is based on control of the disease with bisphosphonates, with the aim of relieving symptoms and correcting laboratory abnormalities. Surgical treatment may also be necessary to correct deformities or treat pathological fractures. This study evaluated the management and course of 8 patients with Paget's disease of bone, followed in the Orthopedic Clinic of this hospital. Among these patients, 1 had concomitant advanced prostate carcinoma, highlighting the association between Paget's disease and secondary bone diseases that can affect the differential diagnosis. Level of evidence IV, Study type: Case Series.

Immunotherapy for allergic rhinitis – a United Kingdom survey and short review

2005 ◽  
Vol 119 (10) ◽  
pp. 799-805 ◽  
Author(s):  
G Dhanasekar ◽  
A B Izzat ◽  
A R D'Souza
Keyword(s):  
Allergic Rhinitis ◽  
Questionnaire Survey ◽  
Management Strategies ◽  
Short Review ◽  
Postal Questionnaire ◽  
University Teaching ◽  
Treatment Modalities ◽  
Common Condition ◽  
Current Management ◽  
The Uk

Allergic rhinitis (AR) is a common condition which is treated using different modalities, including immunotherapy. The aim of this study was to survey the current management strategies among ENT consultants in the UK in treating AR, and their views on immunotherapy. The study design was a postal questionnaire survey and the setting a university teaching hospital. Participants were consultant members of the British Association of Otolaryngologists – Head and Neck Surgeons (BAO-HNS). The main outcome measures were common treatment modalities adopted by the survey group to treat AR, and the number of consultants practising immunotherapy. The majority (81.1 per cent) of the consultants surveyed practise medical therapy with or without surgery. Immunotherapy is advised by 26 per cent of ENT consultants, but only 6.6 per cent currently administer immunotherapy.

scholarly journals Extramammary Paget’s Disease Versus Lichen Sclerosus

2016 ◽  
Vol 16 (3) ◽  
pp. 43-46
Author(s):  
T. Pappova ◽  
J. Pec ◽  
A. Kozarova ◽  
K. Adamicova
Keyword(s):  
Correct Diagnosis ◽  
Paget’S Disease ◽  
Lichen Sclerosus ◽  
Paget's Disease ◽  
Surgical Removal ◽  
Extramammary Paget’S Disease ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Vulvar Paget’S Disease ◽  
Extramammary Paget's Disease

Abstract Burning, itching and dyspareunia are typical symptoms of many genital diseases. These subjective complaints can be misdiagnosed because of different clinical presentations. We present a case report of a postmenopausal woman treated for genital warts over a period of three years followed by the development of leukoplastic lesions in the whitish area clinical classified as Lichen sclerosus (LS). Histology of this lesion revealed carcinoma in situ. After radical surgical removal, vulvar Paget’s disease was histologically verified. LS and extramammary Paget's disease (EMPD) belong to a group of uncommon dermatoses which mainly affect the skin of the genitals in postmenopausal women. Ulceration, erosions and leukoplastic lesions can signalize the development of squamous cell carcinoma in association of lichen sclerosus, on the other hand, they can be the sign of EMPD after a long period of time using different topical agents. The importance of reaching the correct diagnosis is essential and can influence current patient investigations and invasive or non-invasive treatment.

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