Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
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Praneem polyherbal formulations containing purified extracts of Azadirachta indica (neem tree) have shown activity against HIV and sexually transmitted disease pathogens in studies in vitro. The product also has contraceptive properties. This has prompted its development as a possible microbicide. We evaluated the safety of Praneem polyherbal tablet use among HIV-uninfected women. Twenty eligible women were enrolled in a Phase I open-label study requiring 14 days of consecutive intravaginal use of Praneem polyherbal tablets. Nine (45%) participants experienced 17 episodes of genital irritation. Transient genital itching was reported by eight (40%) participants, burning micturation by two (10%) and lower abdominal pain, genital burning and intermenstrual spotting by one (5%) each. On colposcopy, petechial haemorrhage was observed in two participants, one on day 7 and the other on day 14, and both were resolved without any treatment. There were no serious adverse events. Praneem polyherbal tablets were found to be safe for once daily intravaginal use for 14 consecutive days in sexually active HIV-uninfected women and a Phase II study may be taken up as a priority.
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PMID:Phase I safety study of Praneem polyherbal vaginal tablet use among HIV-uninfected women in Pune, India. 1608 47

The objective of this study was to estimate prevalence and risk factors of reproductive tract infections (RTIs) among women in Haiphong, Vietnam. In October 1998, 197 women aged 18-49 were recruited into a community-based, cross-sectional study. Of the 197 women, 95 (49.5%) were diagnosed with > or = 1 endogenous reproductive tract infections (RTI) and 7 (3.6%) with > or = 1 sexually transmitted disease (STD). In three separate multivariate analyses, age <30 years (OR = 2.5; 95% CI = 1.1, 5.8), residential mobility (OR = 2.3; 95% CI = 1.1, 4.9), self reported genital itch/discharge (OR = 2.1; 95% CI = 1.1, 4.1), and reported belief that RTI symptoms were shameful (OR = 2.5; 95% CI = 1.2, 5.0) were associated with bacterial vaginosis (BV); low education was associated with candida (OR = 2.6; 95% CI = 1.0, 6.7); > or = 1 abortion was associated with > or = 1 STD (OR = 9.2; 95% CI = 1.1, 427). The prevalence of STDs was low but the prevalence of endogenous infections was high. Abortion is a proxy for other factors, such as high risk sexual behavior in either the woman or her partner. Given the low prevalence STD in this area of Vietnam, clinical case management of women presenting with RTI symptoms should focus on treatment of the more common endogenous infections, candida and BV.
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PMID:Prevalence and risk factors for reproductive tract infections among women in rural Vietnam. 1677 Dec 33

A 24-year-old lady presented to an evening genitourinary (GU) clinic with a short history of vulval and anal irritation. On perianal examination, several threadworms were visible. Symptoms resolved with oral mebendazole and strict personal and environmental hygiene. Threadworm is a common and easily treatable cause of pruritus ani, yet is underreported in GU literature. If the history is suggestive, consider performing the diagnostic cellophane test and/or prescribing empirical treatment.
Int J STD AIDS 2009 May
PMID:Threadworm: an infrequent clinical finding in a genitourinary medicine clinic attendee presenting with ano-genital irritation. 1981 24

Anal condyloma acuminatum is a human papillomavirus (HPV) that affects the mucosa and skin of the anorectum and genitalia. Anal condyloma acuminatum is the most commonly diagnosed sexually transmitted disease in the United States. To date, there are more than 100 HPV types, with HPV-6, HPV-10, and HPV-11 predominately found in the anogenital region and causing approximately 90% of genital warts. Risk factors for anal condyloma acuminatum include multiple sex partners, early coital age, anal intercourse, and immunosuppression. Transmission occurs by way of skin-to-skin contact through sexual intercourse, oral sex, anal sex, or other contact involving the genital area. The virus may remain latent for months to years until specific mechanisms cause production of viral DNA, leading to the presentation of anal condyloma acuminatum.Patients with anal condyloma acuminatum may be asymptomatic or present with presence of painless bumps, itching, and discharge or bleeding. It is not uncommon to have involvement of more than one area, and multiple lesions may also be present and extend into the anal canal or rectum. To date, there is no serologic testing or culture to detect anal condyloma acuminatum; therefore, diagnosis is made clinically or by detection of HPV DNA. Multiple factors determine the choice of treatment, which may range from patient-applied medications to surgical intervention. Despite treatment choice, recurrence rates are high, indicating the importance of patient education on prevention of HPV infection and reinfection. Unfortunately, at this time, no cure exists for anal condyloma acuminatum; however, recently Gardasil and Cervarix (in Australia only) vaccines have become available and are showing promising results.
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PMID:Anal condyloma acuminatum. 1982 Apr 42

The genital area in women is covered by a keratinized squamous stratified epithelium outside the body (vulva), and a non keratinized epithelium inside the body (vagina). These characteristics can have an effect on the clinical aspects of the diseases and/or on the choice of the treatment. Symptoms (itching, pain, vaginal discharge), preferential localisation of skin diseases (psoriasis, lichen planus, lichen sclerosus, atopic dermatitis and allergic contact dermatitis, irritative dermatitis) and the aspect of primary lesions are to be investigated. The implication of this region in sexual activity places it at risk of sexually transmitted diseases (STD's) and dyspareunia. These have numerous causes that have to be sought and taken care of, often by multidisciplinary teams. After a careful history and clinical examination, additional tests allow to exclude infections or confirm a skin condition or neoplasia by a skin biopsy. If contact dermatitis is suspected, specific allergy testing is done. Treatment starts with correction of harmful habits (excessive use of soaps, inappropriate cosmetic products,...) that add to the local irritation. Patients are then reassured of common misconception regarding cancer, STD's and fertility. In the vast majority of cases, the treatment will target an infection (fungal, bacterial, STD's), will relieve irritation by the use of local immunosuppressant drugs (local corticosteroids) and/or relief itching symptoms with anti-histamine drugs.
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PMID:[How to diagnose and how to treat diseases of the genital mucosa?]. 1989 85

Screening for skin and sexually transmitted diseases was undertaken in 170 pregnant women in all the trimesters of pregnancy. Pruritus was the commonest presenting symptom (58.82%). Candidiasis (21.78%) was the commonest cause of white discharge per vagina, Condylomata acwninata (4.70%) was the commonest sexually transmitted disease. Three patients (1.76%) were seropositive for HIV infection. The commonest dermatological disorder observed was scabies (17.64%) while 48 other diseases accounted for less than 10% each.
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PMID:Skin in pregnancy. 2088 31

When no demonstrable cause is uncovered after excluding inflammatory dermatosis, infectious disease or a manifestation of anorectal disease, anogenital pruritus is often described as 'idiopathic'. Lumbosacral radiculopathy was described by Cohen et al. as one of the possible causes of 'idiopathic' anogenital pruritus. We report a case of a patient with chronic pruritus of the right scrotum that was relieved immediately post-ipsilateral inguinal hernia repair. This is, to the best of our knowledge, the first case of neuropathic scrotal pruritus secondary to direct nerve compression by an inguinal hernia. We propose that a proper examination for the presence of inguinal hernia be performed in the work-up for scrotal pruritus.
Int J STD AIDS 2010 Sep
PMID:A cured patient who came back for consultation: neuropathic scrotal pruritus relieved after ipsilateral inguinal hernia repair. 2109 42

The objective of the study is to investigate products used by women self-treating symptoms of reproductive tract infections (RTIs), including sexually transmitted infections (STIs), and their methods of administration. A household survey using a multi-stage cluster sample design was undertaken in KwaZulu-Natal, South Africa. Women aged 18-60 years were interviewed (n = 867) and information was collected on demographics, reproductive health and sexual behaviours. A fifth of women reported having RTI/STI symptoms (20.5%), of whom 41.9% were treating these symptoms (mostly discharge [79.1%], ulcers [6.8%] and itching [7.7%]). Only three women were using medication prescribed by a health provider, while the remainder were self-treating using traditional medicines and modern products, including antiseptics, soaps, petroleum jelly, menthol creams and alum. Products were administered in various ways. Although RTI/STI treatment is widely available and free in public health facilities, many women are still self-treating. Potential harm of products for self-treatment requires further investigation and efforts should be made to improve STI service uptake.
Int J STD AIDS 2010 Dec
PMID:Use of modern and traditional products to self-treat symptoms of sexually transmitted infections in South African women. 2129 85

A 16-year-old young man presented with intensely itchy erythematous dermatitis on the body for 1 week and vesicular lesions on the palms and soles for 4 to 5 days. Lesions on the palms and soles were accompanied by severe burning and itching. The patient gave a history of sore throat and fever, 1 week prior to the onset of lesions. A general physical examination was normal, and cutaneous examination revealed multiple, well-defined erythematous scaly plaques with collaret scaling on the trunk and extremities (Figure 1). Vesicular lesions were seen on the palms and soles (Figure 2). The differential diagnoses we considered were pityriasis rosea and secondary syphilis. The possibility of dermatophytid, vesicular pityriasis rosea, and pompholyx was limited to the palms and sole lesions. Complete blood cell count was within normal limits. Results from antistreptolysin O titer, potassium hydroxide mount, and venereal disease research laboratory were negative. Skin biopsies were taken from the back and left palm. The biopsy specimen from the back revealed focal spongiosis, lymphocyte exocytosis, vacuolar changes in the basal layer, and perivascular lymphocytic infiltrate in the dermis (Figure 3). The biopsy obtained from the vesicular lesion on the left palm revealed an intraepidermal vesicle with no evidence of acantolytic process (Figure 4). A diagnosis of pityriasis rosea was made and the patient was started on clarithromycin 500 mg once a day for 7 days, along with antihistamines and emollients. The lesions faded dramatically in a very short period, and there was significant involution of almost all of the lesions after 7 days of clarithromycin. During the 6 months of follow-up, no recurrence was observed.
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PMID:Vesicular palmoplantar pityriasis rosea. 2254 32

Pruritus is a common symptom in HIV-infected patients. However, there is a lack of studies examining this symptom. We investigated the prevalence of pruritus and its causes in this population by offering the possibility of participating in a skin health programme to all HIV-infected patients who attended our service in Alicante, Spain. Those who accepted (n = 303) underwent an interview and a detailed physical examination by specialists from the Dermatology Department. Between May 2003 and October 2003, 94 patients (31%) reported pruritus: xerosis, seborrhoeic eczema and interdigital tinea pedis were the most frequent dermatological entities responsible for this symptom. Patients with pruritus had higher viral loads (P = 0.006). We conclude that pruritus is still a frequent symptom in HIV-infected patients. To the best of our knowledge this is the first prevalence study of pruritus in an HIV population in the combination antiretroviral therapy (cART) era.
Int J STD AIDS 2012 Apr
PMID:Pruritus in HIV-infected patients in the era of combination antiretroviral therapy: a study of its prevalence and causes. 2258 48


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