tetracycline and Vulvar-Diseases

Intermittent inflammation of the vulval pilosebaceous units is common and usually self-limiting, but some patients experience recurrent and more troublesome symptoms. There is a scarcity of information on this problem. We describe the clinical and histological features in these patients and the response to treatment. A retrospective, observational study of 16 patients with this phenomenon of recurrent, protracted folliculocentric inflammation of the vulval pilosebaceous unit was performed. Details on the clinical features, histology and response to treatment were collected. Mean age at presentation was 32 years (range 21-45). All patients reported recurrent painful papules and pustules on the labia majora and labia minora. Nine patients reported a cyclical pattern to the development of lesions, with premenstrual exacerbation being most common. Histological examination of these lesions showed a folliculocentric microabscess formation surrounded by an acute and chronic inflammatory cell infiltrate, with a focal foreign-body granulomatous reaction. All our patients responded well to tetracycline, antiandrogenic or retinoid therapy. We propose the term 'vulval acne' for this condition and propose a stepwise approach to its management. We hope to highlight this as a common but underreported entity.

Topics: Acne Vulgaris; Adult; Angiogenesis Inhibitors; Biopsy; Disease Progression; Drug Therapy, Combination; Female; Humans; Inflammation; Middle Aged; Protein Synthesis Inhibitors; Recurrence; Retinoids; Retrospective Studies; Tetracycline; Treatment Outcome; Vulvar Diseases

Topics: Adult; Combined Modality Therapy; Female; Granuloma Inguinale; Humans; Tetracycline; Vulva; Vulvar Diseases

Fifteen patients suffering from symptomatic Gartner cysts were subjected to cyst fluid aspiration and 5% tetracycline injection of a similar volume (as that of aspirated cyst fluid) under local analgesia. Twenty-four hours later the injected tetracycline was re-aspirated until the cyst walls collapsed. The procedure was easy, inexpensive, acceptable by all patients with no operative or postoperative complaints or complications and no cyst reformation. This novel technique is an ideal, safe and effective simple office procedure for management of symptomatic Gartner cysts.

Topics: Cysts; Female; Humans; Sclerotherapy; Suction; Tetracycline; Vaginal Diseases; Vulvar Diseases; Wolffian Ducts

Twenty nine patients with genital fixed drug eruptions were studied during one year. In 15 the genitalia were exclusively affected, whereas the other 14 had cutaneous lesions in addition. It was striking that those whose lesions were exclusively genital reported for consultation much earlier. Drug history was the mainstay of diagnosis. Provocation tests with graded doses of the suspected drug(s) were undertaken in all cases. Tetracycline was the commonest causative drug, followed by oxyphenbutazone and acetylsalicylic acid.

Topics: Adolescent; Adult; Child; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Penile Diseases; Skin Tests; Skin Ulcer; Tetracycline; Vaginal Diseases; Vulvar Diseases

A case of granuloma inguinale of the oral cavity clinically resembling actinomycosis is reported. This condition should be considered in the differential diagnosis of chronic ulcerative lesions of the mouth, especially in patients with associated genital ulcers.

Topics: Actinomycosis; Adult; Diagnosis, Differential; Drug Combinations; Female; Granuloma Inguinale; Humans; Mouth Diseases; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Vulvar Diseases

Two cases of acute vulvar ulcer of Lipschuetz are reported. The present state of knowledge as to the etiology, signs and symptoms, clinical course and treatment of this rare and frequently misdiagnosed entity are discussed.

Topics: Acute Disease; Adolescent; Ampicillin; Female; Humans; Tetracycline; Ulcer; Vulvar Diseases

Over the past 10 years, it has been well established that Crohn's disease may involve any segment of the gastrointestinal tract from the mouth to the anus and may also cause destructive extraintestinal lesions. Extensive cutaneous ulceration has recently been recognized as one of the rare extraintestinal complications. A case of chronic vulvar ulceration due to Crohn's disease is reported. The clinical manifestations and management of such a lesion are discussed.

Topics: Abscess; Adult; Aminosalicylic Acids; Biopsy; Buttocks; Colectomy; Complement Fixation Tests; Crohn Disease; Female; Humans; Ileostomy; Isoniazid; Pregnancy; Skin Ulcer; Steroids; Tetracycline; Vulva; Vulvar Diseases