Histopathology of recurrent mechanical fissure of the fourchette.

Recurrent mechanical fissure of the fourchette may occur as a primary finding with nonspecific histopathologic changes.

Erosive vulvar lichen planus: a cohort at risk for cancer?

Objective: To determine the occurrence of cancer, including vulvovaginal squamous cell carcinoma (SCC), among women after diagnosis of erosive vulvar lichen planus (LP).

Study Design: Retrospective review of 113 patients diagnosed with erosive vulvar LP over an 8-year period (average follow-up, 5 years).

Results: A diagnosis of cancer was made in 5 women after diagnosis of erosive vulvar LP.

Langerhans' cell histiocytosis of the vulva: the Iowa experience.

Background: Vulvar presentation of Langerhans' cell histiocytosis (histiocytosis X) is rare. Symptoms and signs at the time of presentation can include pruritus, pain, dyspareunia, burning, discharge and presence of a discrete lesion and/or generalized ulceration. Once a diagnosis of Langerhans' cell histiocytosis is made, there is no formal treatment protocol.

Bladder and bowel symptoms among women with vulvar disease: are they universal?

Objective: To compare the prevalence of painful bladder syndrome, recurrent urinary tract infections, urinary leakage and irritable bowel syndrome between women with specific vulvar disorders and controls.

Study Design: Women with a primary diagnosis of vulvar intraepithelial neoplasia (dysplasia), vulvar vestibulitis (vestibulitis), contact vulvitis, atrophic vulvovaginitis, lichen simplex, lichen sclerosus and lichen planus, were compared to women presenting for annual examinations.

Results: As compared to controls, painful bladder syndrome was more prevalent among subjects with dysplasia, vestibulitis and contact vulvitis; a history of recurrent urinary tract infection was more prevalent among subjects with contact vulvitis; and urinary incontinence was less prevalent in subjects with lichen sclerosus.

Prolonged vaginal and oral metronidazole for refractory Trichomonas vaginalis: a case report.

Background: Resistant Trichomonas vaginalis infection is typically treated with increased doses of oral metronidazole. Because of side effects that limit compliance, such treatment may be ineffective.

Case: A young woman had an 8-year history of T vaginalis that was refractory to multiple courses of metronidazole, tinidazole and intravaginal paromomycin.