CASE 1
Vulvar pruritus affecting a woman's quality of life
There are 2 main pathogenetic pathways for the development of precursors to invasive squamous cell carcinoma of the vulva (VSCC): human papilloma virus (HPV) related (classic or usual-type
vulvar intraepithelial neoplasia, uVIN) and non-HPV-related (differentiated or simplex
vulvar intraepithelial neoplasia, dVIN).
"As we age and our hormones change, a woman can experience vaginal dryness, atrophy, a condition called Lichens Sclerosis,
vulvar and pelvic pain along with incontinence, and pain with intimacy," Dr.
Vulvar cancer typically spreads through the inguinofemoral lymph nodes and traditionally en bloc resection of these nodes is performed as their status is an important prognostic factor.
Pharmaceutical company Duchesnay Inc said on Tuesday that it has filed its supplemental New Drug Application with the US Food and Drug Administration (FDA) seeking a new indication for Osphena (ospemifene) for moderate to severe dyspareunia, a symptom of
vulvar and vaginal atrophy (VVA) due to menopause.
Ryan Suk, from the University of Texas Health Science Center in Houston, and colleagues used data from nine cancer registries of the Surveillance, Epidemiology, and End Results database to identify 113,272 patients (73,085 female and 40,187 male) patients with HPV-associated cancers (cervical, vaginal,
vulvar, oropharyngeal, anal, and penile) diagnosed from 1973 through 2014.
TRANSCUTANEOUS ELECTRICAL NERVE stimulation (TENS) was effective at treating chronic
vulvar pain at the vestibule in combination with vaginal diazepam and with placebo in a randomized, double-blind, placebo-controlled trial.
Vulvodynia, defined as a chronic idiopathic
vulvar pain, remains a condition of mystery for urologists.
SAN DIEGO -- Over the past few years, pediatric dermatologist Kalyani Marathe, MD, has been seeing young patients with
vulvar diseases in a multidisciplinary
vulvar dermatology clinic at Children's National Health System, in Washington.
It is four times frequent in
vulvar area relative to perianal area and average age of involvement in perianal lesions is higher than
vulvar lesions.
The first is associated with human papilloma virus (HPV) infection that causes 86.7% of
vulvar intraepithelial neoplasia (VIN) and 28.6% in invasive
vulvar cancer from the study of the worldwide HPV genotype attribution in over 2000 cases of VIN and
vulvar cancer [2].
Vulvar ISCC can be classified into two groups according to pathogenic mechanism: basaloid (warty) carcinoma and keratinizing carcinoma.