Granuloma Inguinale

D efinition —A sexually transmitted disease, marked by ulceration, caused by the intercellular, gram-negative rod Klebsiella granulomatis . Clinical Features Epidemiology Endemic in tropical and subtropical areas in sexually active adults. Sporadic outbreaks do occur in Western countries. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Chancroid

D efinition —Infection secondary to infection with Haemophilus ducreyi marked by painful ulcers and adenopathy. Clinical Features Epidemiology Most common in tropical and subtropical developing countries. It is more common in males than females and is commonly seen in the setting of human immunodeficiency virus (HIV) infection. Chancroid is a risk factor for heterosexual transmission of HIV. You’re Reading a Preview Become a Clinical Tree membership…

Syphilis

PITFALL D efinition —A sexually transmitted disease caused by the spirochete Treponema pallidum . Clinical Features Epidemiology Primary syphilis typically occurs in young, sexually active adults. Secondary and tertiary disease is much less common due to the effectiveness of antibiotic treatment of the primary infection. Secondary syphilis develops in weeks to months in untreated individuals. Tertiary syphilis will occur in one third of untreated individuals. You’re…

Chronic Erosive Herpes Simplex

PITFALL D efinition —A chronic herpes simplex virus (HSV) infection lasting more than 1 month. Clinical Features Epidemiology This is the most common ulcerative disease of the genital tract in developed countries. A prevalence of upward of 20 million cases has been reported in the United States. Chronic erosive HSV infection can be seen in HIV-positive patients and is an AIDS-defining illness if the lesions last…

Acute Herpes Simplex Virus Infection

D efinition —An ulcerative sexually transmitted disease (STD) caused by the herpes simplex virus (HSV) (double-stranded DNA). Clinical Features Epidemiology The most common ulcerative disease of the genital tract in developed countries. A prevalence of upward of 20 million cases has been reported in the United States. Chronic erosive HSV infection can be seen in human immunodeficiency virus (HIV)–positive patients and is an AIDS-defining illness if…

Molluscum Contagiosum

D efinition —A viral infection of the skin (often sexually transmitted when involving the genital area) caused by a DNA poxvirus. Clinical Features Epidemiology Genital infection most commonly occurs in young, sexually active individuals. In this population it is commonly transmitted by sexual or fomite contact. Cases in children are generally not sexually transmitted. You’re Reading a Preview Become a Clinical Tree membership for Full access…

Bacterial Vaginosis

D efinition —Infection marked by a shift in the vaginal flora. Caused by a decrease in the normal lactobacilli and an increase in numerous other organisms ( Gardnerella vaginalis , Mobiluncus , Mycoplasma hominis , Prevotella , Porphyromonas , Bacteroides , and Peptostreptococcus ). Clinical Features Epidemiology Most commonly present in young, sexually active women; however, it can be seen across a wide age group. You’re…

Vulvovaginal Candidiasis

D efinition —A fungal infection caused by any member of the Candida species of fungi. Clinical Features Epidemiology Very common, affecting up to 75% of females starting after menarche and increasing in incidence with peaks in the third or fourth decades. Predisposing factors include diabetes; immunocompromised state; and steroid, antibiotic, and oral contraceptive use. You’re Reading a Preview Become a Clinical Tree membership for Full access…

Vulvodynia

D efinition —The sensation of pain localized to the vulvar vestibule. Clinical Features Epidemiology Once thought to be a relatively rare condition, it is now known to affect millions of women. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Crohn’s Disease of the Vulva

D efinition —A granulomatous, inflammatory bowel disease that may spread to involve other sites such as skin and mucosa. Clinical Features Epidemiology Seen in patients with Crohn's disease. Crohn's disease has no gender predilection and usually manifests in the second to third decade of life. Vulvar involvement may be contiguous (i.e., fistula formation) or may be isolated (metastatic Crohn's disease) with lower gastrointestinal symptoms. You’re Reading…

Hidradenitis Suppurativa

D efinition —A suppurative inflammatory process that can be associated with fistula tract or abscess formation. Clinical Features Epidemiology Most commonly seen in young women. The most common sites of involvement are the axilla and groin. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Epidermolytic Hyperkeratosis

D efinition —Hyperkeratosis marked by discrete, flesh- to white-colored papules to plaques. This entity overlaps with what is called acantholytic dyskeratosis (a term under which other dyskeratoses might fall). In this section we discuss a process that is encountered sporadically. Clinical Features Epidemiology Epidermolytic hyperkeratosis is an uncommon condition with no demographic predilections. You’re Reading a Preview Become a Clinical Tree membership for Full access and…

Darier’s Disease

D efinition —Autosomal dominant genodermatosis marked by numerous hyperkeratotic papules that usually involve the trunk. Clinical Features Epidemiology Patients present around puberty; however, they can present later in life. Men are more severely affected; however, the incidence is equal in men and women. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member.…

Hailey-Hailey Disease

D efinition —An autosomal dominant, acantholytic dermatosis with a predilection for moist body creases. Clinical Features Epidemiology It is a rare autosomal dominant disease. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Pemphigus Vulgaris

D efinition —An acquired autoimmune (anti–desmoglein 3 antibodies) blistering disorder that is marked by flaccid bullae and mucosal erosions. Clinical Features Epidemiology Incidence is rare and the disease may affect all age groups. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Bullous Pemphigoid

D efinition —An autoimmune blistering disorder that is the most common cause of subepidermal blisters. Caused by antibodies to a 230 kD plakin (BPAg1) and a 180 kD glycoprotein (BPAg2). Clinical Features Epidemiology Primarily seen in older patients and is commonly associated with other autoimmune disorders (lupus, diabetes, primary biliary cirrhosis, ulcerative colitis, and alopecia areata). You’re Reading a Preview Become a Clinical Tree membership for Full access…

Zoon’s Vulvitis

D efinition —Plasma cell–mediated vulvitis of unknown etiology. Clinical Features Epidemiology A rare condition. Has also been reported in men, as balanitis chronica circumscripta plasmacellularis. Age range is from 25 to 70 years, with middle-aged women most commonly being affected. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Lichen Planus

D efinition —An uncommon idiopathic mucocutaneous inflammatory dermatosis with a prototypical lichenoid tissue reaction pattern, and a wide range of clinical presentations. Clinical Features Epidemiology Women at ages of 30 to 60 years. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Lichen Sclerosus Including Early Lichen Sclerosus

D efinition —A chronic inflammatory dermatosis of unknown etiology that commonly affects the vulva. Clinical Features Epidemiology More commonly seen in perimenopausal and postmenopausal patients; however, can be seen at any age. Associations have been made with vulvar intraepithelial neoplasia (VIN) and certain human leukocyte antigen (HLA) haplotypes. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership…

Seborrheic Dermatitis

D efinition —A chronic, recurrent dermatitis occurring in areas where sebum is produced marked by red plaques with a yellow scale. Clinical Features Epidemiology Common. Affects all demographic groups. Immunosuppressed patients and patients with some chronic conditions (including congestive heart failure and Parkinson's disease) have more severe disease and may develop generalized seborrheic dermatitis. The disease characteristically flares in winter and spring, with the resolution of…