Benign Disease of the Female Reproductive Tract: Symptoms and Signs

목차

A. Abnormal Bleeding

B. Pelvic Mass

C. Vulvar Conditions

D. Naginal Conditions

본문내용

ocytic nevi
* 생검 후 대개 지혈의 위하여 suture는 필요 없고, 국소로 silver nitrate사용
(2) Other Vulvar Conditions
* Pseudofolliculitis
* Fox-Fordyce disease
* Acanthosis nigricans
* Hidradenitis suppurativa
(3) Vulvar Tumors, Cysts, and masses
* Condyloma acuminata(C.A); very commom vulvar lesion
---> topical tri - and bichloroacetic acid
* Molluscum contagiosum
* Condyloma lata
* Table 13.11
* Epidermal inclusion cyst
<--- result from the bruial of fragments of skin after the trauma of childbirth or episiotomy
* Bartholin duct cyst
; duct 폐쇄로 mucus가 축적 / 대부분 무증상
infection되어 abscess형성시 pain 심하고 크기 증가
* Skene duct cysts
(5) Vulvar Ulcers
; HSV / syphilis / LV / GI / Crohn's disease / Behcet's disease
Lichen planus
<5> Postmenopausal Women
: Sx. --- itching / soreness / dyspareunia
(1) Vulvar Dystrophis
: numerous terms -- leukoplakia / lichen sclerosis et atrophicus
atrophic and hyperplastic vuluitis / kaurosis vulvae
: malignant potential of vulvar dystrophis; <5%
1) Squamous Hyperplasia
* most often in postmenopausal women
* Pruritis ; MC Sx
* thickened and hyperkeratotic / may be excoriation
* 치료 ; topical fludrinated corticosteroid ointment 3회 / D for 6 weeks
2) Lichen Sclerosus
* the most common white lesion of the vulva
* occur at any age but most common among postmenopausal women
* 증상 ; pruritus, dyspareunia, burning
* Dx. ; 조직생검(invasive cancer is only rarely associated with lichen s)
* 치료 ; 2% testosterone cream 2회 / D for 3잔 ---> 1회 D for 3잔
0.05% clovetasol(80%만족)
superficial vulvectomy (recurrence are common after surgical)
3) Mixed Dystrophy
* 약 20% of vulvar dystrophies
* Sx. ; burinng / pruritus / dyspareunia
* 치료 ; fluorinated corticosteroid oint 3회 / D for 6-8잔
---> 그후 2% testosterone oint 3회 / D for 6-8잔
local excision in severe atypia area
(2) Urethral Lesions
: urethral caruncles / prolapse of the urethral mucosa
--->more commonly among older women
--->치료 ; topical or systemic estrogen cream
D. Naginal Conditions
: Vaginal discharge is one of the most commonvaginal Sx.
1. Vaginitis ; candidiasis / chlamydia cervicitis / BV/ Cx. Ca
2. Retained foreign body ; tampon, pessary
3. Ulcerations ; tampon-induced, lichen planus
4. Malignancy ; cervical, vaginal
5. Postmenopausal atrophic vagintis
6. Postradiation vulvovaginitis
<1> Pediatric
* Sexual abuse should always be considered in prepubertal children with vaginal discharge
* Vulvovaginitis is usually caused by multiple organisms that are present in the perineal area
---> 치료 ; focus on hygiene and cleaning
topical estrogens and antibiotics for 4주 이하
<2> Adolescence and Older
* Toxic shock syndrome
- associated with tampon use
- Staphylococcus aureus-produced exoyoxins
- 증상 ; fever / hypotension / diffuse erythema with desquamation of the
palms and soles
* Fibroepithelial polyps
* Garther's duct cysts
- mesonephric origin
- usually present on the lateral vaginal wall
- not require treatment
* Vaginal adenosis
* Bulging lesion of the vagina and vulvar area
---> cystocele / rectocele / urethrocele

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