Bladder Papilloma As A Rare Cause Of Urogenital Bleeding In A Prepubertal Girl

There are different causes of urogenital bleeding in prepubertal girls. These include vulvovaginitis, urinary infections, urethral prolapse, urethral caruncle, vaginal foreign bodies, hormonal causes, tumors, posterior labial fusion, lichen sclerosis. Among the tumors, rhabdomyosarcoma and papilloma are prominent. In this article, a case of urogenital hemorrhage due to papilloma located at the base of the bladder was presented and the relevant literature was reviewed

Possibilities of skin ultrasound examination in the management of patients with localized scleroderma

With the help of ultrasound examination (ultrasound), it is possible to visualize the skin of patients with suspected localized scleroderma, as well as to objectively determine the stage of the disease and assess the effectiveness of therapy. Three patients with linear, plaque forms of scleroderma, as well as lichen sclerosus, underwent skin ultrasound using a Skinscanner DUB TPM device with a 75 MHz transducer, 4 mm penetration, 21 m resolution in the area of lesions and in adjacent areas of healthy skin, using their ratio coefficient (RC) for comparative evaluation. The thickness of the epidermis and dermis, their echogenicity were determined. With a linear form of scleroderma, an increase in the thickness of the epidermis in the area of the focus (RC 0.850.0125) and a decrease in its echogenicity (RC 1.580.46) were observed. The echogenicity of the dermis was significantly reduced in the lesion (RC 3.021.17). The dermis thickness was slightly less in the center of the lesion (RC 1.09), at the periphery of the lesion it was moderately increased (RC 0.86). In the plaque form of scleroderma, a decrease in the echogenicity of the epidermis was observed in the foci (RC 1.320.49); an increase in the thickness of the dermis (RC 0.790.16) and a decrease in its e echogenicity (RC 1.260.57). In 7 of 11 foci, a subepidermal hypoechoic band was visualized. With lichen sclerosis in the foci, an increase in the thickness of the epidermis (RC 0.420.12) and its acoustic density (RC 0.630.0793), a decrease in the thickness and echo density of the dermis (RC 1.320.00943 and RC 1.550.6, respectively). With different forms of LS, a different ultrasound picture was observed, depending on the stage and activity of the process. The changes identified during treatment reflect the effectiveness of the therapy and the rate of restoration of the skin structure during therapy.

The effect of vulvar lichen sclerosus on sexual dysfunction

Lichen sclerosus (LS) is a chronic inflammatory dermathosis that affects the vulva. Many women with LS complain about pain in the vulva, which usually often affects a patient’s life quality. This study describes the results of comparing the sexual function of patients with vulva lichen sclerosis (VLS) with reports of pain and without, to a control group of healthy people.The objective: a determination of the spread of sexual dysfunction in women with VLS.Materials and methods. On the basis of the gynecological office for routine screening / preventive care of the outpatient department in the National Cancer Institute and the clinic “Verum”, a case-control study was carried out to determine the relationship between VLS and sexual dysfunction. A total of 235 women were included in the study. 140 women with a confirmed by biopsy the diagnosis VLS were compared with a control group. We studied the current health complaints, medical and surgical history, current symptoms such as pain and itching, the type and frequency of sexual intercourse and level of satisfaction with sexual activity. The assessment of the severity of pain was carried out according to the McGill scale, the type and frequency of sexual relations and the level of satisfaction with sexual activity - according to the results of questionnaires.Results. Women with VLS reported less sexual activity than women of the control group (p=0.007). In the study, sexually active women with VLS were significantly less likely to report vaginal intercourse (71.6%) than «healthy» controls (89.0%, p=0.003), although similar proportions of all groups indicated that vaginal contact was important for them. Satisfaction with the quality of sexual activity was significantly lower among the women with VLS compared with the control group of «healthy» patients. 25% of women with VLS reported that sexual activity was rarely or never satisfying, compared with 2,11% of the control group of healthy women (p<0.0001).Conclusion. Women with vulva lichen sclerosis have less frequent and less satisfying sexual activity compared to the control group.

HCV poly U/UC sequence–induced inflammation leads to metabolic disorders in vulvar lichen sclerosis

Vulvar lichen sclerosis (VLS) is a dermatologic disorder that affects women worldwide. Women with VLS have white, atrophic papules on the vulva. They suffer from life-long intense pruritus. Corticosteroids are the first-line of treatments and the most effective medicines for VLS. Although VLS has been speculated as an autoimmune disease for a long time, its pathogenesis and the molecular mechanism is largely unknown. We performed a comprehensive multi-omics analysis of paired samples from VLS patients as well as healthy donors. From the RNA-seq analysis, we found that VLS is correlated to abnormal antivirus response because of the presence of Hepatitis C Virus poly U/UC sequences. Lipidomic and metabolomic analysis revealed that inflammation-induced metabolic disorders of fatty acids and glutathione were likely the reasons for pruritus, atrophy, and pigment loss in the vulva. Thus, the present study provides an initial interpretation of the pathogenesis and molecular mechanism of VLS and suggests that metabolic disorders that affect the vulva may serve as therapeutic targets for VLS.

Cutaneous Horn of the Glans

Cutaneous horn is a protuberance constituted by compact keratinous material, with a hard consistence similar to a horn, which occurs more frequently in photoexposed areas. The authors describe a case of cutaneous horn on the glans considered a rare location. Verrucous carcinoma was the histopathological diagnosis of the base of the horn and lichen sclerosis, the precursor lesion.

Use of autologous platelet-rich plasma in treatment of genital forms of scleroatrophic lichen

The article provides an overview of the use of platelet-rich plasma (PRP) for the treatment of lichen sclerosis (LS). The definition, principle of operation and main characteristics of this method are given. Studies showing the effectiveness of PRP method were analyzed. Based on our research, we believe that PRP may be an alternative to treatment with topical corticosteroids. The method is a new treatment method for LS, which requires further randomized controlled trials.