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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The potential sequelae of Chlamydia trachomatis--nonspecific urethritis and post gonococcal urethritis in men and nonspecific genital infection in women--suggest a need for a chlamydial diagnostic service in clinics that treat sexually transmitted diseases. In this prospective study, over 2000 endocervical samples were obtained over an 18-month period from women presenting to a sexually transmitted diseases clinic. The isolation rate for chlamydia averaged 23.6%/month. There was no significant difference in presenting symptoms such as vaginal discharge, dysuria, pruritus, and abdominal pain between patients with chlamydial infection alone, those with gonorrhea alone, and women with no sexually transmitted disease. 178 (31%) of patients with chlamydia were sexual contacts of patients with nonspecific urethritis and 122 (22%) were contacts of men with gonorrhea. In the absence of a chlamydial service laboratory, only contacts of patients with nonspecific urethritis are likely to receive treatment, leaving 2/3 of chlamydia-positive women untreated. In 1976, an estimated 18,300 women were seen in British clinics with undiagnosed, untreated chlamydial infection. Given the magnitude and severity of this problem, a chlamydial diagnostic service should become a mandatory clinic component.
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PMID:The need for a chlamydial culture service. 48 48

In a study to determine the significance of Bacteroides ureolyticus in the lower urogenital tract using a new selective and differential medium, this organism was isolated from 30.1% of asymptomatic men, 37.8% of men with genital warts, and 26.3% of men with non-gonococcal urethritis. Using the same selective medium B. ureolyticus was isolated from 49% of women attending the same genitourinary clinic with symptoms of vaginal discharge and/or pruritus vulvae, 44.1% of asymptomatic women, and 50% of asymptomatic women attending a local family planning clinic. Furthermore, this organism was isolated from 27.1% of women whose vaginal specimens isolated commensal organisms only, 43.2% with C. albicans, 59.4% with U. urealyticum, 74.4% with M. hominis, and 76.8% with G. vaginalis. On testing with the API ATB 32A test strips, 86% of the positive isolates of B. ureolyticus from the female genital tract were indistinguishable from those isolated from the male genital tract indicating that this organism is common to the lower genital tract of both sexes. These results indicate that B. ureolyticus is a commensal in the lower genital tract.
Int J STD AIDS
PMID:Significance of Bacteroides ureolyticus in the lower genital tract. 157 80

Sexual activity is the primary method of transmission for several important parasitic diseases and has resulted in a significant prevalence of enteric parasitic infection among male homosexuals. The majority of parasitic sexually transmitted diseases involve protozoan pathogens; however, nematode and arthropod illnesses are also included in this group. Trichomoniasis, caused by Trichomonas vaginalis, is the most common parasitic STD. Infection with this organism typically results in the signs and symptoms of vaginitis. Trichomoniasis can be diagnosed in the office setting by performing a microscopic evaluation of infected vaginal secretions and can be successfully treated with metronidazole. Both pediculosis pubis, caused by the crab louse Pthirus pubis, and scabies, caused by the itch mite Sarcoptes scabiei, present with severe pruritus. A papular or vesicular rash and linear burrows seen in the finger webs and genital area are characteristic of scabies. Pediculosis pubis is diagnosed by observing adult lice or their nits in areas that bear coarse hair. The diagnosis of scabies is confirmed by scraping suspicious burrows and viewing the mite or its byproducts under the microscope. Lindane, 1% used in treating scabies, is also very effective for treating pediculosis pubis. Synthetic pyrethrins, also applied as a cream or lotion, are less toxic alternatives for the treatment of either condition. Oral-anal and oral-genital sexual practices predispose male homosexuals to infection with many enteric pathogens, including parasitic protozoans and helminths. The most common of these parasitic infections are amebiasis, caused by Entamoeba histolytica, and giardiasis caused by Giardia lamblia. Both entities may cause acute or chronic diarrhea, as well as other abdominal symptoms. Most gay men with amebiasis are asymptomatic, and invasive disease in this group is extremely rare. Both amebiasis and giardiasis can be diagnosed on the basis of microscopic examination of stool specimens, although duodenal aspiration is occasionally necessary to confirm a diagnosis of giardiasis. Multiple treatment regimens exist for amebiasis. Iodoquinol is a good choice for asymptomatic cyst carriers, whereas the combination of metronidazole plus iodoquinol is used for symptomatic patients. Quinacrine and metronidazole are both efficacious in the treatment of giardiasis.
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PMID:Sexually transmitted parasitic diseases. 201 32

A case of vulvar giant lichenification of Pautrier showed uncommon ulcerations in the center of hyperplastic verrucoid plaques. The diagnosis was made from the history, clinical findings and characteristic features on the skin biopsy. Other causes of vulvar ulcers, such as venereal disease, chronic bullous and autoimmune diseases, and neoplastic conditions were excluded. We treated the patient with systemic antihistamines, topical antiseptics and corticosteroids, and sublesional injections of triamcinolone. The itch-scratch cycle was interrupted by the patient's wearing cotton gloves at night. Complete healing of the ulcers and an improvement in the pruritus was achieved within 14 weeks.
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PMID:Giant lichenification of the vulva with marked ulcerations. A case report. 207 63

The most commonly encountered vulvar dermatoses present as cutaneous papules or scaly plaques. The two major categories are the papulosquamous disorders, which include psoriasis, seborrhoea and the 'lichens' (lichen planus, lichen sclerosus, lichen simplex chronicus) and chronic or recurrent infections (tinea, Candida, papillomavirus, herpes simplex). These conditions are morphologically similar, and treatment for one condition may affect the appearance of another. Lichen simplex chronicus (LSC, histologically squamous cell hyperplasia) is a secondary dermatosis, a non-specific cutaneous change indicating the presence of pruritus. Candida, tinea, lichen sclerosus, papillomavirus and topical agents have all been implicated in the development of LSC. Chronic vulvar burning (vulvodynia) is rarely associated with cutaneous change other than erythema, but may occur with vulvar dermatoses, occult Candida or papillomavirus infection, vulvar vestibulitis or cutaneous dysaesthesias. Topical preparations are most commonly used to treat vulvar disorders. Treatment trials typically require several weeks of therapy to determine responses. Allergic reactions to components must be distinguished from irritants, and complications of therapy must be recognised and prevented if possible. Overuse of topical medications, especially steroids, may lead to mycotic superinfection or to rebound dermatoses related to steroid withdrawal. Anxious patients may overclean or overtreat sensitive genital skin in the belief that they are unclean or harbour a sexually transmitted disease. In some situations, systemic medication may offer an appropriate adjunct or alternative to topical therapy.
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PMID:Vulvar dermatoses: common problems in dermatological and gynaecological practice. 209 34

A total of 100 heterosexual adults of either sex with frequent episodes of recurrent genital herpes were allocated to treatment with either Genivir (DIP-253) 1% cream or placebo cream. All patients had genital herpes previously verified by a positive viral culture. The study was carried out as a double-blind parallel group trial. Fifty patients were allocated to each of the two treatment groups. The treatment was initiated within 24 hours after the first sign of a recurrence, and at the pretreatment examination all patients had developed typical lesions with blisters and/or sores. At baseline a sample for herpes virus culture and typing was obtained. The creams were applied four times daily for five days. Follow-up examinations were carried out on days 1, 2, 4 and if needed on days 7, 10 and 14. The major factor used for assessment of efficacy was the time to complete healing of all lesions. Duration of pruritus and pain were also recorded. In the group of patients treated with Genivir cream the time to complete healing was 3.3 days and in the placebo group 6.1 days. The difference was statistically significant (P less than 0.001). The mean duration of pain was 1.3 days in the Genivir group and 2.5 days in the placebo group: this difference also reached significance (P less than 0.01). The duration of pruritus was about the same in both groups. The active agent in Genivir, DIP-253, is a heterocyclic aromatic complex with confirmed anti-herpetic activity and with evidence of a local immunomodulatory effect. It was concluded that the efficacy of topical application of DIP-253 may be due to combined antiviral and immunomodulatory activities.
Int J STD AIDS 1990 Jan
PMID:Genivir (DIP-253) 1% cream versus placebo cream in the treatment of recurrent genital herpes: a double-blind study. 209 94

This study reports the rates of Chlamydia trachomatis genital infection in two groups of university men. One hundred twenty-seven came to the student health center with genitourinary complaints, and 29 were identified as the sexual partners of women with chlamydia infections. Evidence of chlamydial infection was found in 29 (22.8 percent) of those presenting with complaints and in 6 (20.7 percent) who were contacts of chlamydia-infected women. Comparison of all symptomatic patients with sexually active controls without genitourinary complaints showed that the symptomatic patients had significantly more frequent exposures to different sexual partners and that they, or their partners, were more likely to have had a sexually transmitted disease. Chlamydial urethritis was significantly more frequent than "nonspecific" urethritis in symptomatic patients who claimed membership in a campus fraternity (P = 0.004). Complaints more likely to be noted with chlamydia included itching (P = 0.004), burning on urination (P = 0.0325), and purulent discharge (P = 0.036).
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PMID:Chlamydia trachomatis urethritis in university men: risk factors and rates. 218 10

The author analyzes the clinical data and paraclinical characteristics of patients with paraneoplastic bullous dermatoses, followed up at the Research Institute of Skin and Sexually Transmitted Diseases in the town of Gorki since 1980. Clinical features of Duhring's paraneoplastic dermatoses were detected, consisting in dissemination of the process with involvement of facial skin and with essential itching. Paraclinical characteristics are as follows: neither eosinophils, nor acantholytic cells are detectable in the vesicular contents, Jadassohn's test is negative, histomorphologic examination shows intraepidermal localization of the vesicle. In paraneoplastic pemphigus involvement of the mucosae alone was recorded, and the painful syndrome whose severity did not correlate with the depth of the pathologic foci; corticosteroid therapy has proved ineffective. The author recommends thorough examinations of patients with bullous dermatoses if they present with the aforesaid clinical and paraclinical characteristics.
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PMID:[Paraneoplastic bullous dermatoses]. 218 62

Although molluscum contagiosum, scabies, and infestation by crab lice do not carry the requirements of partner notification or other long-term consequences, they are among the most commonly reported sexually transmitted disease. Molluscum contagiosum is a benign viral infection of the skin epidermal layer, most often transmitted by intimate skin-to-skin contact. The lesions often resolve spontaneously over time, but patient discomfort or social reasons may require destructive removal of the lesions. Scabies is caused by the Sarcoptes scabiei mite. The victims continually itch, especially at night, and often seek over-the-counter topical remedies before seeing a clinician. Once a correct diagnosis is made, successful resolution of this disease and its itching can be achieved. Head and pubic lice account for most of the more than three million cases of louse infestation treated in the United States each year. Symptoms of infestation generally include itching that leads to scratching, erythema, irritation, and inflammation. A careful diagnosis followed by disinfection, symptomatic treatment, and psychologic support should result in a complete cure with no long-term effects.
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PMID:The "nuisance" sexually transmitted diseases: molluscum contagiosum, scabies, and crab lice. 224 49

Analyses of the possible presence of human papilloma virus (HPV) DNA were performed on 84 biopsies from 50 women with clinically and histopathologically suspected HPV infection of the vulva. The colposcopic criteria for inclusion in the study were: acetowhite flat lesions with or without fissures and/or diffuse hyperplastic mucosa with a granulated or filamental surface. Directed biopsies for histopathology and DNA hybridization (dot-blot and Southern-blot) were taken. All women had histopathological evidence of HPV infection. Twelve women had cervical and/or vulvar neoplasia. HPV DNA could be demonstrated in the vulvar biopsies from 24 women; 13 women had HPV 16, 3 had HPV 18, HPV 31 and HPV 33, respectively. In addition, 10 biopsies contained HPV DNA of unknown types. Fifty-five percent of granulated and filamental lesions and 43% of flat lesions with or without fissures were positive for HPV DNA. 34 women had one or more of the following symptoms: itching, burning, dyspareunia, discharge, fissures, dryness and dysuria. Papillomavirus vulvitis is a sexually transmitted disease which may cause recalcitrant symptoms and/or concomitant neoplasia. It is thus important to recognize the different symptoms and signs of this disease.
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PMID:Papilloma virus infection of the vulva. 255 1


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