Management of vulval itching caused by benign vulval22
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This document discusses the management of vulval itching caused by benign vulval dermatoses. It begins by defining pruritis vulvae as vulval itching with a desire to scratch, which can be caused by infections, dermatoses, neoplasms, medical disorders, hygiene issues, or psychosocial factors. It describes taking a thorough history including symptoms, duration, treatments tried, hygiene practices, potential irritants, and other medical conditions. Key dermatoses discussed include lichen sclerosus, lichen planus, atopic eczema, seborrhoeic dermaitis, contact dermatitis, psoriasis, and lichen simplex chronicus. Treatment principles
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Usually, dryness appears on hands, elbows, feet, knees, and the face. Rashes on contaminated areas start to itch and become even more inflamed when scratched. This illness is not infectious, but it is long-lasting.
Moreover, its intensity may change during the lifespan. Some children may overgrow the allergy while others remain highly vulnerable. The current disease can cause additional illnesses. Symptoms and intensity of skin inflammation are specific to each patient.
There is a variety of eczema types. Besides the most popular case, atopic dermatitis, there are about six other disease
variants, different in their methods of treatment and side effects.
All of them should be identified with the help of a specialist to ensure a specific approach for each case. Atopic dermatitis is the most widely spread type of disease. It is common among children and is often associated with asthma and hay fever.
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Each case is different in its look and side effects. The only common thing for them is that they are types of sore and dry skin that should not be scratched.
There is no single opinion regarding the cause of eczema. According to the latest research, various types of illnesses are caused by their different principles. Particularly, for the children of eczema-ill parents, the probability of developing the illness is much higher.
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RED LESIONS
Red lesions of the oral mucosa can be caused by a variety of factors including trauma, infections, inflammatory conditions, and systemic diseases. Erythematous candidiasis presents as erythematous patches or areas on the tongue and palate caused by Candida infections. Lichen planus causes erythematous lesions that may be difficult to distinguish from other conditions like erythema multiforme. Reactive lesions like pyogenic granulomas and peripheral giant cell granulomas develop in response to local irritation or trauma. Geographic tongue appears as migrating erythematous lesions surrounded by white borders on the dorsal tongue.
Surgical site infection
This document discusses various surgical site infections including:
1. Boils, carbuncles, and hidradenitis suppurativa which are infections of hair follicles and sweat glands caused by bacteria like Staphylococcus aureus. Treatment involves antibiotics and drainage.
2. Impetigo, a contagious skin infection in children caused by Staphylococcus or Streptococcus that forms blisters and crusts. It is treated with oral antibiotics and topical antiseptics.
3. Septicemia and pyemia, serious bloodstream infections that can lead to organ dysfunction or failure. Gram-positive infections commonly originate from the skin while gram-negative infections often start in
SINGLE ULCERS
The document discusses various types of single ulcers that can occur in the oral mucosa. The most common type is a traumatic ulcer, which is usually caused by mechanical, chemical, thermal or self-inflicted trauma. Traumatic ulcers present as tender lesions that vary in size and shape and can persist for weeks. Differential diagnoses include carcinomatous and recurrent aphthous ulcers. Other single ulcers discussed include eosinophilic ulcers of the tongue, histoplasmosis, blastomycosis, mucormycosis, and syphilitic ulcers. Diagnosis involves biopsy and cultures. Treatment depends on the specific condition but may include topical steroids, antifungal agents
Mucocutaneous
This document discusses various mucocutaneous disorders of the oral cavity, including genodermatoses, infective causes, and non-infective conditions. It provides details on specific diseases such as erythema multiforme, pemphigus, and cicatricial pemphigoid. Erythema multiforme is characterized by target lesions that can involve the oral mucosa. Pemphigus is a chronic blistering disease caused by loss of cell adhesion, while cicatricial pemphigoid involves subepithelial blistering that results in scarring.
Urethritis
This document discusses urethritis and balanoposthitis. It begins by defining urethritis as inflammation of the urethra and describing the different types of urethritis including gonococcal and non-gonococcal causes. It then focuses on gonococcal urethritis caused by Neisseria gonorrhoeae. It describes the clinical features, investigations, management, and complications of gonococcal and chlamydial urethritis. The document then defines balanoposthitis as inflammation of the glans penis and prepuce. It discusses the various etiologies, clinical features, investigations, and management of balanoposthitis.
BACTERIAL120INFECTIONS.pptx
This document discusses various cutaneous bacterial infections caused by Staphylococcus and Streptococcus bacteria, including impetigo, ecthyma, cellulitis, folliculitis, furuncles, carbuncles, scalded skin syndrome, toxic shock syndrome, perianal cellulitis, and dactylitis. It provides details on the causative organisms, clinical features, investigations, differential diagnoses, and management of each condition.
Pathology of Skin - Common Disorders
The document discusses various skin conditions including acute and chronic inflammatory diseases, infections, and neoplasms. It provides details on the pathogenesis, clinical features, and histopathology of conditions like urticaria, eczema, psoriasis, lichen planus, impetigo, fungal infections, viral infections including warts and molluscum, and acne. Case studies are presented to demonstrate clinical presentations.
Newer Insights on Hidradenitis Suppurativa.pptx
Hidradenitis suppurativa (HS) is an inflammatory disorder that is characterized by chronic deep-seated nodules, abscesses, fistulae, sinus tracts, and scars in the axilla, inguinal area, submammary folds, and perianal area. This disfiguring condition is accompanied by pain, embarrassment, and a significantly decreased quality of life. Although the mechanism of HS has not been entirely elucidated, lesion formation is believed to center around follicular hyperkeratosis within the pilosebaceous-apocrine unit. Recent research has provided new insight into the role of cytokines in the pathogenesis of HS, helping close some existing knowledge gaps in the development of this condition.
desquamative ginigivitis
This document provides an overview of desquamative gingivitis, a group of immune-mediated disorders that cause inflammation and sloughing of the gingival epithelium. It discusses the classification, associated disorders like lichen planus and pemphigoid, clinical presentation, histopathology, diagnosis and treatment. Desquamative gingivitis can be caused by conditions like mucous membrane pemphigoid, lichen planus, and pemphigus vulgaris. It is characterized by red, swollen gingiva with areas of denudation and vesicles. Diagnosis involves clinical evaluation, histopathology, and immunopathology testing. Management depends on the underlying disorder but may include top
Acne,eczema and pemphigus.pptx
1. Acne is a common skin condition affecting hair follicles, most often on the face and upper body, caused by changes in hormones, stress, and bacteria. Eczema is a skin inflammation caused by genetic and environmental factors like allergens that results in rashes, itching, and dry skin. Pemphigus is a rare autoimmune blistering disease where the immune system attacks the skin and mucous membranes, causing fluid-filled blisters.
2. Nursing management for these conditions focuses on preventing infection by promoting gentle skin care, avoiding irritants, managing itching and pain, and ensuring adherence to medication regimens which can include topical corticosteroids and oral antibiotics or
Lesions of oral cavity
This document summarizes common lesions of the oral cavity, including ulcers caused by infections (viral like herpes, bacterial like Vincent's infection, fungal like candidiasis), immune disorders (aphthous ulcers, Behcet's syndrome), trauma, skin disorders (lichen planus, pemphigus vulgaris), and submucous fibrosis caused by chewing areca nut. It describes the etiology, clinical features, and management of each condition. Major types of oral ulcers and lesions are infections, immune disorders, trauma, neoplasms, and skin disorders that may manifest in the oral cavity.
Medical Comorbidities and their impacto on wound healing
This document discusses how medical comorbidities can impact wound healing. It emphasizes that treating the wound is only part of the story - managing the patient's underlying medical problems is also critical for healing. Several common comorbidities that can impair healing are described in detail, including diabetes, rheumatoid disease, nutritional deficiencies, medications, chemotherapy/radiation, and smoking. A thorough history and physical exam is important for identifying potential impediments to healing from comorbidities.
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Management of vulval itching caused by benign vulval22
- 2. MANAGEMENT OF VULVAL ITCHING CAUSED BY BENIGN VULVAL DERMATOSES BY DR KIRAN JAVED PGR GYNAE “ B” UNIT LRH PESHAWAR
- 3. PRURITIS VULVAE Sensation of vulval itching with a desire to scratch CAUSES INFECTIONS….candidiasis,trichomonas vaginalis,pediculosis,scabies DERMATOSES…. NEOPLASIA…VIN,carcinoma,lymphoma,pagets disease MEDICAL DISORDERS…DM,CKD,cirrhosis,hemochromatosis,polycythemia HYGIENE PSYCHOSOMATIC AND PSYCHOSOCIAL
- 4. HISTORY
- 5. EXAMINATION
- 6. Vulval history taking Question Key symptoms,their severity and impact on patient’s functions? Duration?? Associated symtopms? Treatments in the past? Reasoning Important, as itch can be a symptom of skin disease or infection.Pain may be primarily due to pain syndrome or secondary to skin damage due to scratching.Improvement in functions (daily life activities,sex etc) are important outcomes. Acute :vulvovaginal thrush or contact dermatitis Chronic : lichen planus or lichen sclerosis E.G vaginal discharge, vulval pain, other skin diseases. Inappropriate treatment may exacerbate the present condition or may give rise to another condition. E.g topical steroids will exacerbate fungal infections
- 7. Question How does the patient clean the vulval area? Contacts with irritants such as soaps, shampoos, urine, and scented vaginal wipes? Any systemic illness?? Any other skin conditions present? Reasoning Many women feel unclean and can overwash, leading to skin damage and further irritation. damage the skin, potentially causing inflammation. Urine is a potent skin irritant. For example, diabetes, renal failure, anaemia, autoimmune conditions (including family history of autoimmunity) For example, eczema or psoriasis (sometimes hidden as cracking behind the ears, a scaly scalp or umbilical erythema)
- 8. TERMINOLOGY
- 12. INVESTIGATIONS VAGINAL SWABS VULVAL BIOPSY All areas of vulval malanosis and new or changing pigmented lesion Persistently eroded lesions Indurated and suspicious ulcers Poor response following initial diagnosis PATCH TESTING
- 14. LICHEN SCLEROSUS Chronic ,autoimmune ,inflammatory skin condition with a predilection for genital skin in both men and women CLINICAL APPEARANCE Porcelain white papules and plaques ,ecchymosis,erosions,fissures Late signs are loss of anatomy with fusion and adhesions Lichenification Figure of 8 DIAGNOSIS Clinical Biopsy PRI TREATMENT Superpotent topical steroids and emollients
- 16. LICHEN PLANUS Chronic autoimmune condition CLINICAL APPEARANCE Classical …violaceous ,well demarcated plaques with overlying lacy white lines Erosive …glazed erythema or errosions symmetrical pattern at vaginal introitus ,raised edges DIAGNOSIS Clinical Biopsy PRI TREATMENT
- 18. ATOPIC ECZEMA CLINICAL APPEARANCE Symmetrically inflammed ,erythematous,weepy skin DIAGNOSIS Clinical PRI TREATMENT Moderate or potent topical steroid plus emollients
- 20. SEBORROEIC ECZEMA CLINICAL APPEARANCE Glazed skin ,erythema and fine scaling in interlabial sulci DIAGNOSIS Clinical PRI TREATMENT
- 22. CONTACT DERMATITIS CLINICAL APPEARANCE Irritant ..poorly defined erythema at site of irritant Allergic…erythema extends beyond irritant With or without excoriation DIAGNOSIS Clinical Patch testing PRI TREATMENT Moderate or potent topical steroid plus emollient Strict avoidance of irritant
- 24. PSORIASIS
- 26. LICHEN SIMPLEX