外阴-阴道-牙龈综合征型扁平苔藓1例

报告1例外阴-阴道-牙龈综合征型扁平苔藓。患者女,50岁。因口腔溃疡伴疼痛5年,外阴糜烂伴疼痛2年就诊。患者曾多次被诊断为口腔扁平苔藓,给予相应治疗,无明显疗效。皮肤科检查:右颊黏膜、上下牙龈、阴道口及小阴唇下方均见糜烂。皮损组织病理检查符合扁平苔藓组织学改变。本例属糜烂型扁平苔藓的变型。     

外阴-阴道-牙龈综合征一例

患者女,55岁.1984年口腔出现一处黄豆大小糜烂面,未予治疗.1986年外阴出现湿疹样改变,到北京某医院就诊,诊断为扁平苔藓并外阴白斑,给予自制中药及糖皮质激素治疗后好转.1990年,出现口唇青紫,外阴轻度萎缩,自行用药治疗.自2002年开始,口唇青紫逐渐加重,并出现牙龈红肿,到当地医院就诊,排除心血管系统病变,对症治疗后未见好转,后自服大蒜油2个月,口腔糜烂好转.     

外阴-阴道-牙龈综合征临床研究

目的 探讨外阴-阴道-牙龈综合征(VVGS)的临床特征及治疗策略.方法 收集11例VVGS患者的临床资料并进行分析.结果 11例VVGS确诊时的平均年龄和中位年龄均为46岁,平均病程4年.疼痛糜烂性红斑位于阴道前庭7例,齿龈10例,双侧颊黏膜5例;性交疼痛8例;阴道溢血4例.7例应用小剂量甲泼尼龙联合羟氯喹或秋水仙碱,4例仅口服羟氯喹,11例患者均外用0.1%他克莫司软膏,8例获痊愈或显效,未见明显不良反应.结论 VVGS多见于中年女性,痛性红斑好发于阴道前庭和齿龈,性交疼痛常见.甲泼尼龙联合羟氯喹片及单独应用羟氯喹治疗轻症患者疗效好.0.1%他克莫司软膏可作为局部维持治疗的药物之一.     

120例健康育龄妇女阴道sIgA浓度检测及其与阴道念珠菌感染的关系

用放射免疫法检测了１２０例健康育龄妇女、４１例念珠菌性阴道炎患者和２９例阴道念珠菌带菌者阴道ｓＩｇＡ的浓度。念珠菌性阴道炎组根据白带直接镜检下念珠菌的形态分为两组：以孢子、芽管为主者为念珠菌性阴道炎１组，以菌丝为主者为念珠菌性阴道炎　组。结果表明，健康育龄妇女阴道ｓＩｇＡ浓度范围为２０６．０　１００．１　ｇ／ｍｌ，念珠菌带菌者阴道ｓＩｇＡ与健康对照组无差异。念珠菌性阴道炎　组阴道ｓＩｇＡ低于健康对照组，念珠菌性阴道炎　组则相反。     

阴康宁治疗细菌性阴道病97例疗效观察

细菌性阴道病(Bacterial Vaginitis BV)过去曾称为非特异性阴道炎、阴道嗜血杆菌性阴道炎、加特纳菌性阴道炎等,直到1984年在斯德哥尔摩有关此病的国际会议上才正式使命为细菌性阴道病。BV为育龄期妇女最常见的阴道感染性疾病,由加特纳杆菌与某些厌氧菌共同作用,所致的菌群失调。     

阴道白念珠菌细胞外磷脂酶活力测定

目的　探讨白念珠菌细胞外磷脂酶活力与外阴阴道念珠菌病的关系。方法　随机选择外阴阴道念珠菌病患者和无症状携带者 ,采用卵黄平皿方法测定其阴道白念珠菌分离株的细胞外磷脂酶活力。结果　患者组细胞外磷脂酶阳性菌株的检出率及其磷脂酶的活力均显著高于携带者组 (P值均 <0 .0 0 1)。结论　白念珠菌细胞外磷脂酶可能是引起外阴阴道念珠菌病的重要毒力因子之一。     

外胚叶发育不良-皮肤脆性综合征一家系基因突变研究

目的:对国内首例外胚叶发育不良-皮肤脆性综合征的家系进行基因突变的研究。方法:收集家系资料,提取外周血DNA,采用PCR扩增斑菲素蛋白1(plakophilin1,PKP1)基因的编码区全部外显子,DNA直接测序,明确突变位点。针对所发现的突变以SmaⅠ或BsrSⅠ酶进行限制性内切酶检测。应用逆转录(RT)-PCR进一步明确家系的致病原因。结果:先证者PKP1基因有3个突变。第5外显子供体端杂合剪接突变(INS5+1G>T),第5外显子杂合的同义突变(1053T>A),这两种突变位于同一条等位基因上,由母亲遗传而来。第10内含子剪接受体端杂合突变(INS10-2A>G),由父亲遗传而来。这3种突变为国际首次报道。突变可能导致无义突变介导的mRNA降解。结论:在1例外胚叶发育不良-皮肤脆性综合征的先证者中检出有PKP1基因的复合性杂合突变,它们分别由无症状的致病基因携带者父母遗传而来。     

阴股沟皮瓣修复女性外阴部乳房外湿疹样癌切除后缺损

目的探讨女性外阴部乳房外湿疹样癌彻底切除后创面应用阴股沟皮瓣修复的方法和效果。方法根据女性会阴部阴股沟区的应用解剖学基础和手术切除术后缺损创面大小,设计同侧的阴股沟皮瓣修复外阴部皮肤恶性肿瘤切除后创面。结果 5例外阴部乳房外湿疹样癌患者切除后阴股沟皮瓣修复,皮瓣全部成活,随访3年,术区外形良好,未见复发,效果满意。结论阴股沟皮瓣血供安全可靠,操作简便,成活率高,旋转修复方便,适合修复外阴部皮肤恶性肿瘤切除后创面。     

Vulvovaginal candidiasis complicating recurrent bacterial vaginosis

In this study the authors reveal a high incidence of asymptomatic and symptomatic vulvovaginal yeast infection in patients with recurrent bacterial vaginosis. Symptomatic yeast vaginitis in these patients presents frequently as a mixed infection with symptoms and signs of both clinical entities being present simultaneously. The authors diagnosed vulvovaginal candidiasis in 10 (29%) out of 35 patients with a history of recurrent bacterial vaginosis; vulvovaginal candidiasis and bacterial vaginosis together were detected in 12 (34%) out of 35 women. Optimal therapeutic results usually require concomitant treatment of both candidal vaginitis and bacterial vaginosis. The lack of specificity of signs and symptoms of vaginitis mandates that women with recurrent bacterial vaginosis, for each symptomatic recurrence, be examined and evaluated by the use of simple laboratory tests to determine a specific diagnosis. Failure to appreciate the frequency of candida superinfection leads to empirical and inappropriate therapy for bacterial vaginosis.     

Vulvovaginal Candida infection: current perspectives

Candida Vulvovaginitis remains the subject of considerable research attention. Yeast species other than Candida albicans are being incriminated with increasing frequency as causes of vaginitis in some recent publications, while analysis of C. albicans strain types by DNA fingerprinting has provided preliminary evidence that the fungus may be able to make minor adaptations of its genotype that facilitate vaginal colonization. The current perception of C. albicans as a potentially virulent microbe relates several molecular factors to invasive processes. These include secretion of hydrolytic enzymes, in particular a proteolytic enzyme, and an inherent tendency to rapid phenotypic switching. Molecular biological experimentation with the genes determining secretion of enzymes should be able to demonstrate definitively the role played by such proteins in the pathogenetic process.     

Vulvovaginal carriage of yeasts other than Candida albicans

AIMS: We investigated the spectrum of yeasts isolated, and compared the epidemiological and laboratory characteristics of women carrying vulvovaginal Candida albicans with those carrying yeasts other than C. albicans. METHOD: Between April and June 2001, 5802 consecutively received genital swabs from women were plated onto Candida ID chromogenic media (BioMerieux). Blue colonies were reported as C. albicans; all other colonies (white and pink) were identified to species level using the Vitek YBC card (BioMerieux). In vitro susceptibility to amphotericin (AMB), fluconazole (FLU), itraconazole (ITZ), and voriconazole (VOR) was determined for approximately 40% of non-C. albicans yeasts using a standardised microdilution method. RESULTS: Yeast was isolated from 1221 women (21%). Of these, C. albicans only was isolated from 1087 (89%) and yeasts other than C. albicans from 129 (11%) women. C. glabrata comprised 89 (69%) of the latter. Women in whom other yeasts were recovered were older than those with C. albicans (mean 43, versus 33 years, p <0.001). All isolates tested (n=53) were susceptible to AMB and VOR. Seven (24%) C. glabrata strains were susceptible to FLU with 21 (72%) testing susceptible-dose dependent. CONCLUSION: Yeasts other than C. albicans are common vaginal isolates even in a primary care population. The species isolated are less susceptible to FLU than most C. albicans.     

外阴阴道念珠菌病的治疗

念珠菌感染是一种十分常见的妇科疾病 ,在无症状的女性人群中 ,2 0 %的女性阴道或外阴部位可分离到白色念珠菌 ,75 %的女性一生中至少要感染一次生殖道念珠菌病(ＶｉｌｖｏｖａｇｉｎａｌｃａｎｄｉｄｉａｓｉｓＶＶＣ) ,而约半数的妇女感染过多次 ,约有 5 %的患者成为复发性或慢性生殖道念珠菌病〔1〕。阴道内环境的改变是引起念珠菌致病的先决条件之一 ,现已证明 ,下列因素与该病关系十分密切 ,妊娠、口服避孕药、糖尿病、抗生素的使用导致的菌群失调以及免疫抑制性疾病。近年来 ,由于性传播疾病的流行和蔓延 ,滥用抗生素的现象比较突出 ,…     

外阴阴道念珠菌病免疫机制的研究进展

外阴阴道念珠菌病是流行广泛的常见疾病,长期以来一直困扰着全球广大的妇女,对妇女的身心健康造成很大的影响。念珠菌是一种机会性致病菌,宿主对念珠菌的识别和免疫应答是其免疫系统与念珠菌相互作用的结果,其防御机制仍然不明,现在多数学者认为阴道黏膜上皮细胞的先天性抗念珠菌活性及局部免疫在抗念珠菌感染中发挥着重要作用,但目前细胞免疫与体液免疫的保护作用仍有争议。