Genital Symptoms and their Non-STI Cause Flashcards
What do the symptoms from microbes result from?
The microbe themselves and aberrant immune response
What causes vulvovaginal candidosis?
90% candida albicans
Can be C. glbraata et al
Usually acquired from bowel
What are risk factors for vulvovaginal candidosis?
Changes in host’s environment trigger pathogenicity - e.g. antibiotics disrupting flora of vagina or skin irritation
RF incl. DM, steroids, immunosuppression, pregnancy, reproductive age group (oestrogen)
How do you diagnose VV candidosis?
Hx
Ex: fissuring (fish ring, erythema with satellite lesions, cottage cheese discharge)
Ix: gram stained prep, culture (Sabouraud’s medium) but these are shite
What symptoms do you get in VV candidosis?
Itchy and cottage cheese discharge
What is the appearance of candida albicans?
Pseudohyphae and budding cells
How do you treat VV candidosis?
Clotrimazole 500mg PV once + clotrimazole HC if vulvitis or
Fluconazole 150mg PO once
Avoid irritants/Rx of dermatitis
What is the commonest cause of vaginal discharge?
BV
What are the symptoms of BV?
Watery grey/yellow fishy discharge
May be worse after period/sex as semen alkalinity causes release of amines (fishy)
Sometimes sore/itchy from dampness
What bacteria tends to cause BV?
Gardnerella vaginalis
(Tends to be imbalance of bacteria, esp low lactobacilli)
Biofilm forms (adheres to vaginal wall)
What is BV associated with?
Sex and vit D deficiency in black woman
What are the complications of BV?
Endometritis w. uterine instrumentation/delivery
Premature labour
Increased risk of HIV acquisition
How do you diagnose BV?
Characteristic findings/history
Gram stained smear of vaginal discharge may show biofilm of adherent organisms
How do you treat BV?
Metronidazole (PO/vaginal gel)
Clindamycin PV
May settle itself
Recurrent ?metronidazole premenstrually
What is balantitis?
Inflammation of the glans of the penis
What can cause balantitis?
Poor genital hygiene, contact allergies, topical irritants, drug reaction, bacterial infection, yeast infection (gives blochy red appearance)
What is posthtitis?
Inflammation of the foreskin
What is Zoon’s balanitis?
Aka plasma cell balantitis
Inflammation of foreskin and glands due to overgrowth of commensals and foreskin failure
In which group of people does zoon’s balantitis tend to be in?
Old, uncircumcised men
How do you treat zoon’s balantitis?
Circumcision
What causes impetigo?
Staph aureus or strep pyogenes
What is the appearance of impetigo?
Yellow crusted lesions with surrounding erythema
What is erysipelas?
Superficial infection of upper dermis and superficial lymphatics caused by GAS
What are the clinical features of erysipelas?
Sudden onset, sharply dermarcated, tender, erythematic, oedematous warm patches and plaques
What can erysipelas cause?
Permanent scarring of lymphatic vessels
What are dermatophytes?
Fungal species infecting keratinised tissue (skin/hair/nails)
AKA tinea
In which group of people are dermatophyte infections most common?
Immunocompromised individuals
What is tinea cruris?
Fungal infection of inguinal area
Pruritic erythematous plaques with scaley raised border
What is erythrasma?
Superficial bacterial infection caused by Corynebacterium minutissimum that causes scaley, pruritic, hyperpigamented rashes
What things may lead to perceived genital problems?
Regretted sexual encounter
Problems in life
Mental illhealth
What is your approach to perceived problems?
Acknowledge them
Offer reassurance and benign alternative explanation
What is fox-Fordyce spots?
Normal sebaceous glands under glans/vulva when you stretch the skin
What are vulval papillomatosis?
Fine projections of vestibular epithelium
What are penile pearly papules/coronal papillae?
Normal bumps at bottom of glans
What are Tyson’s glands?
Smooth bumps around frenulum
What are the other causes of genital symptoms?
Dynias
Dermatoses
Congenital, e.g. congenital cysts of labia
Traumatic, e.g. ruptured frenulum
Neoplastic
Manifestations of skin dx, e.g. Lichen sclerosis
