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Background In Western countries, lichen sclerosus is a common disease that affects commonly middle-aged females that present most commonly as a disease of genital and anal regions in both sexes while extra-genital involvement is less frequent. Objective To record all cases of lichen sclerosus in Iraqi population as one of Middle East country and to do a full clinical evaluation and to be compared with published literature as seen in Western countries. Methods This is a cross-sectional descriptive study where all patients with lichen sclerosus were recorded during the period from 2013-2022. All demographic features were estimated and full history and examination were carried out. A histopathological assessment was performed as a confirmatory test. Results All data related to 28 patients with lichen sclerosus were registered and evaluated. The age of patients has a bimodal peak in incidence from prepubertal to a postmenopausal age group and ranged from 8-63 years with a median of 40 years with 24 (85.7%) females and 4 (14.2%) males with a ratio of 6:1. The clinical features of the disease were found to be genital involvement in three (10.7%) patients, one male with follicular lesions of penis and two females with vulval involvement: one with extensive atrophy of vulva while the other with very early lesions). While 25 (89.2%) cases with extragenital sites where the trunk and limbs were the main locations but lips were affected in one female patient another one the ears were involved. The primary lesions in almost half of the cases were follicular whitish sclerosed macules, some with follicular plugs. These lesions over time coalesced together into larger whitish ivory leukoderma in the form of patches and plaques. The rash was localized in 22 (78.6%) cases while extensive in 5 (17.9%) patients. The lesion was asymptomatic apart from slight discomfort and itching but was severe intractable itching in the female genitalia. The HE-stained sections showed complete atrophy of the epidermis with complete sclerosis of the dermis leaving sub-epidermal cleft. Conclusion Lichen sclerosus is a disease of females that commonly presents with extragenital whitish sclerosed leukoderma in the form of follicular macules, patches and plaques while female genital involvement is a rare presentation. The likelihood of extragenital lichen sclerosus following the Blaschko lines was pronounced. [ABSTRACT FROM AUTHOR]

Abstract Background To the best of our knowledge, this is the first report of female genital system infiltration of T-cell lymphoma in veterinary literature. Case presentation A 1.5-year-old, intact female Golden Retriever was referred due to melena and hyporexia that lasted for three weeks. Fever (40.5℃), tachycardia, tachypnoea, pale mucous membranes, and purulent vaginal discharge were identified on physical examination. Blood analyses revealed leucocytosis, anaemia, hypoalbuminemia, and increased lactate and C-reactive protein levels. On abdominal radiography, the small intestine was moderately deviated because of an oval-shaped mass (13 cm × 8.7 cm) located in the mid-abdomen. An enlarged tubular-shaped structure that had the opacity of soft tissue located in dorsal to the bladder to the middle of the abdomen, and an oval-shaped mass (5.28 cm × 3.26 cm), which was suspected to be a medial iliac lymph node located at the sixth to seventh lumbar level. Abdominal ultrasonography revealed gas and fluid in the lumen of the uterine horn with a severely thickened wall, round enlarged lymph nodes around the genitourinary system, and free fluid in the abdominal cavity. Based on these results, pyometra was suspected, and an exploratory laparotomy was performed for ovariohysterectomy. The resected ovary and uterus were macroscopically hypertrophied. Histopathological examination of the ovary and uterus revealed neoplastic proliferation of large round cells with strong immunoreactivity for CD3, indicating T-cell lymphoma. Therefore, the young dog was diagnosed with genital lymphoma. Conclusions The present report describes T-cell lymphoma infiltrating the uterus and ovaries in a young dog, which is rarely diagnosed and could aid in the differential diagnosis of genital diseases in young dogs.

Incorrect and delayed diagnosis of vulvar high‐grade squamous intraepithelial neoplasia (vHSIL) and lichen sclerosus (LS) increases malignant progression risks and negatively impacts prognosis and quality of life. There is a need to improve diagnosis and monitoring. Reflectance confocal microscopy is a non‐invasive imaging tool that visualizes skin structures at cellular resolution. The objectives were to explore feasibility and patient acceptability of vulvar RCM imaging and to identify RCM characteristics that are discriminative for vulvar HSIL and LS. This was a prospective, cross‐sectional, observational clinical trial in patients with vHSIL and LS compared to healthy volunteers. RCM images and vulvar tissue samples were obtained. Five (5) patients with vHSIL, 10 patients with LS and 10 healthy volunteers were enrolled. In total, 100 image series of vulvar skin were obtained, including lesional and nonlesional sites. The RCM technique was considered acceptable for application by patients and healthy controls. Healthy vulvar skin was characterized by a homogenous, normal honeycomb patterned epidermis and a clear epidermal‐dermal junctions. Vulvar HSIL and LS displayed an atypical honeycomb pattern of the epidermis and lymphocytic influx with presence of melanophages. Distinct features specifically observed in LS included the presence of hyalinised vessels and sclerotic areas in the dermis. RCM is a non‐invasive imaging technique that is feasible and clinically acceptable to apply on vulvar skin, both in patients with premalignant lesions and healthy controls. Recognition and validation of disease‐specific characteristics could make reflectance confocal microscopy a clinical tool to non‐invasively aid identification of vulvar premalignancies. [ABSTRACT FROM AUTHOR]

Mycoplasma genitalium (MG) infections are a growing concern within the field of sexually transmitted infections. However, diagnostic assays for M. genitalium have been limited in the United States. As most infections are asymptomatic, individuals can unknowingly pass the infection on, and the prevalence is likely to be underestimated. Diagnosis of M. genitalium infection is recommended using a nucleic acid test. This multicenter study assessed the performance of the cobas Trichomonas vaginalis (TV)/MG assay (cobas) for the detection of M. genitalium, using 22,150 urogenital specimens from both symptomatic and asymptomatic men and women collected at geographically diverse sites across the United States. The performance was compared to a reference standard of three laboratory-developed tests (LDTs). The specificity of the cobas assay for M. genitalium ranged from 96.0% to 99.8% across symptomatic and asymptomatic men and women. The sensitivities in female vaginal swabs and urine samples were 96.6% (95% confidence interval [CI], 88.5 to 99.1%) and 86.4% (95% CI, 75.5 to 93.0%), respectively. The sensitivities in male urine and meatal swab samples were 100% (95% CI, 94.0 to 100%) and 85.0% (95% CI, 73.9 to 91.9%), respectively. This study demonstrated that the cobas assay was highly sensitive and specific in all relevant clinical samples for the detection of M. genitalium.

Abstract Background: Vulvar diseases are common in the general population and have a negative impact on the quality of life. Objectives: To describe our experience as dermatologists in the management of vulvar dermatosis consultations. Methods: A retrospective observational study was conducted with patients who attended monographic vulvar consultations over a 5-year period. Clinical information was obtained from the patient’s charts. Results: 148 women were studied. Their mean age was 43.24 years (standard deviation: 15.15 years), with ages ranging from 4 months to 80 years. 53.4% of patients took between 2 and 5 years to seek medical attention for the first time. The most frequent diagnosis was lichen sclerosus (41.9%), irritative eczema of the vulva (14.9%), and lichen simplex chronicus (10.1%). 83.8% reported anogenital itching, 66.2% pain, and 45.9% dyspareunia. The most frequently prescribed treatment was ultra-potent topical corticosteroids (clobetasol propionate; 41.2%). Patients with lichen sclerosus were significantly older than those who presented with any of the other diseases. No differences were found in terms of either the time of disease evolution or in symptom presentation. Study limitations: Retrospective study. Vulvar diseases with an infectious cause are usually managed in primary care, therefore, were not included. All patients were recruited from a single private hospital which limits the comparisons with the public health system. Conclusions: Vulvar diseases frequently occur and are associated with high morbidity. It is essential to promote the development of specific vulvar consultations in hospitals. Specialties such as dermatology, gynecology, urology, or physiotherapy must be part of these units.

Surgery is the standard treatment for genital extramammary Paget disease (gEMPD). To determine if gEMPD treatments and outcomes differ by sex and US region. A systematic review was performed of all English-language studies on initial gEMPD treatment in Medline via PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. At least 2 reviewers performed title and abstract review and data extraction. Surgical categories included total skinning procedures, partial skinning procedures, Mohs micrographic surgery (MMS), or unspecified surgery. Chi-squared tests of association were used for comparisons. A total of 60 studies comprising 302 (79.7%) female and 77 (20.3%) male patients met criteria. Women were most often initially recommended partial skinning procedures. In all, 74 (24.5%) women and 0 men underwent a total skinning procedure. Men were more likely to be offered MMS than women (40.3% vs 1.9%, P <.0001), despite men having a significantly greater extent of disease involving the perineum and perianal skin (21.1% vs 1.7%, P <.0001). Treatment recommendations varied by US region. Only 20 states were represented. Women are more frequently offered total skinning procedures for gEMPD while men are more frequently offered MMS. MMS offers less recurrence and morbidity than total skinning procedures and should be recommended equally to both female and male patients with gEMPD. [ABSTRACT FROM AUTHOR]

The human body represents a complex and diverse reservoir of microorganisms. Although the human microbiome remains poorly characterized and understood, it should not be underestimated, since recent studies have highlighted its importance in health. This is especially evident when considering microbiota in the male reproductive system, responsible for men's fertility and sexual behavior. Therefore, the aim of this systematic review is to provide an overview of the microbial communities of the healthy male genital mucosa and its role in disease. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was limited to the English language and studies published until August 2022 that included culture-independent techniques for microbiome characterization in male genital mucosa. Ten articles were included. The bacterial composition of the male genital mucosa consists of several genera including Prevotella, Finegoldia, Peptoniphilus, Staphylococcus, Corynebacterium, and Anaerococcus, suggesting that the male genital microbiome composition shows similarities with the adjacent anatomical sites and is related with sexual intercourse. Moreover, male circumcision appears to influence the penile microbiome. Despite the lack of knowledge on the male genital mucosa microbiome in disease, it was reported that Staphylococcus warneri and Prevotella bivia were associated with balanoposthitis, whereas Enterobacteriaceae, Prevotella, and Fusobacterium were more abundant in male genital lichen sclerosus. The limited data and paucity of prospective controlled studies highlight the need for additional studies and established criteria for sampling methods and the microbiome assay procedure. Such a consensus would foster the knowledge about the composition of the genital microbiome of healthy males and its role in disease. [ABSTRACT FROM AUTHOR]

We present a woman with an unusual case of secondary syphilis after an unnoticed primary infection. She initially presented with multiple grayish plaques and nodules on the vulva associated with an erythematous macular symmetrical rash affecting the trunk and extremities. Despite the increasing incidence of sexually transmitted diseases such as syphilis, presentation with unusual manifestations can lead to a delayed diagnosis.

The human body represents a complex and diverse reservoir of microorganisms. Although the human microbiome remains poorly characterized and understood, it should not be underestimated, since recent studies have highlighted its importance in health. This is especially evident when considering microbiota in the male reproductive system, responsible for men’s fertility and sexual behavior. Therefore, the aim of this systematic review is to provide an overview of the microbial communities of the healthy male genital mucosa and its role in disease. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was limited to the English language and studies published until August 2022 that included culture-independent techniques for microbiome characterization in male genital mucosa. Ten articles were included. The bacterial composition of the male genital mucosa consists of several genera including Prevotella, Finegoldia, Peptoniphilus, Staphylococcus, Corynebacterium, and Anaerococcus, suggesting that the male genital microbiome composition shows similarities with the adjacent anatomical sites and is related with sexual intercourse. Moreover, male circumcision appears to influence the penile microbiome. Despite the lack of knowledge on the male genital mucosa microbiome in disease, it was reported that Staphylococcus warneri and Prevotella bivia were associated with balanoposthitis, whereas Enterobacteriaceae, Prevotella, and Fusobacterium were more abundant in male genital lichen sclerosus. The limited data and paucity of prospective controlled studies highlight the need for additional studies and established criteria for sampling methods and the microbiome assay procedure. Such a consensus would foster the knowledge about the composition of the genital microbiome of healthy males and its role in disease.

Abstract Background Increased reports of Neisseria meningitidis urethritis in multiple U.S. cities during 2015 have been attributed to the emergence of a novel clade of nongroupable N. meningitidis within the ST-11 clonal complex, the “U.S. NmNG urethritis clade”. Genetic recombination with N. gonorrhoeae has been proposed to enable efficient sexual transmission by this clade. To understand the evolutionary origin and diversification of the U.S. NmNG urethritis clade, whole-genome phylogenetic analysis was performed to identify its members among the N. meningitidis strain collection from the Centers for Disease Control and Prevention, including 209 urogenital and rectal N. meningitidis isolates submitted by U.S. public health departments in eleven states starting in 2015. Results The earliest representatives of the U.S. NmNG urethritis clade were identified from cases of invasive disease that occurred in 2013. Among 209 urogenital and rectal isolates submitted from January 2015 to September 2016, the clade accounted for 189/198 male urogenital isolates, 3/4 female urogenital isolates, and 1/7 rectal isolates. In total, members of the clade were isolated in thirteen states between 2013 and 2016, which evolved from a common ancestor that likely existed during 2011. The ancestor contained N. gonorrhoeae-like alleles in three regions of its genome, two of which may facilitate nitrite-dependent anaerobic growth during colonization of urogenital sites. Additional gonococcal-like alleles were acquired as the clade diversified. Notably, one isolate contained a sequence associated with azithromycin resistance in N. gonorrhoeae, but no other gonococcal antimicrobial resistance determinants were detected. Conclusions Interspecies genetic recombination contributed to the early evolution and subsequent diversification of the U.S. NmNG urethritis clade. Ongoing acquisition of N. gonorrhoeae alleles by the U.S. NmNG urethritis clade may facilitate the expansion of its ecological niche while also increasing the frequency with which it causes urethritis.

Abstract This study assessed the impacts of an ointment on treatment efficacy, side effects and global tolerance of most common genital diseases. This observational study enrolled symptomatic patients with LS and psoriasis under maintenance therapy (topical steroids); patients with condyloma acuminata treated with liquid nitrogen and/or imiquimod; patients suffering from vulvodynia under multidisciplinary treatment. The tested ointment was added to the usual treatment. Subjective and objective clinical scores, tolerance and Dermatology Life Quality Index (DLQI) were evaluated. One hundred patients completed the study: 26 LS, 6 psoriasis, 52 CA and 16 vulvodynia. There were significant reductions in global symptom and clinical scores for LS (−80.61% and −59.20%, respectively, mean follow-up 66 days) and psoriasis (−82.88% and −82.80%, respectively, mean follow-up of 51 days). The DLQI decreased by 40.17% for LS and 76.92% for psoriasis. The use of ointment resulted in low post-treatment scores for CA (Symptom score: 1.92/maximum 50, clinical score: 2.46/24 maximum, mean follow-up of 17 days). Tolerance was good for all except two patients (one CA, one vulvodynia). Our results indicated the daily applications of an ointment improved treatments for lichen sclerosus, psoriasis (symptoms, clinical signs and quality of life) and for condyloma acuminata (reduced healing time) and was well tolerated during vulvodynia.

This study assessed the impacts of an ointment on treatment efficacy, side effects and global tolerance of most common genital diseases. This observational study enrolled symptomatic patients with LS and psoriasis under maintenance therapy (topical steroids); patients with condyloma acuminata treated with liquid nitrogen and/or imiquimod; patients suffering from vulvodynia under multidisciplinary treatment. The tested ointment was added to the usual treatment. Subjective and objective clinical scores, tolerance and Dermatology Life Quality Index (DLQI) were evaluated. One hundred patients completed the study: 26 LS, 6 psoriasis, 52 CA and 16 vulvodynia. There were significant reductions in global symptom and clinical scores for LS (−80.61% and −59.20%, respectively, mean follow-up 66 days) and psoriasis (−82.88% and −82.80%, respectively, mean follow-up of 51 days). The DLQI decreased by 40.17% for LS and 76.92% for psoriasis. The use of ointment resulted in low post-treatment scores for CA (Symptom score: 1.92/maximum 50, clinical score: 2.46/24 maximum, mean follow-up of 17 days). Tolerance was good for all except two patients (one CA, one vulvodynia). Our results indicated the daily applications of an ointment improved treatments for lichen sclerosus, psoriasis (symptoms, clinical signs and quality of life) and for condyloma acuminata (reduced healing time) and was well tolerated during vulvodynia. [ABSTRACT FROM AUTHOR]

While urogenital diseases of the female African hedgehog (Atelerix albiventris) are common, such diseases in male animals appear rare. This case report describes a male African pygmy hedgehog presenting with urethral obstruction due to accessory gland enlargement. Preputial cystostomy provided effective treatment, and enabled maintenance of good quality of life over the long term. This suggests that preputial cystostomy may offer an effective salvage technique for African pygmy hedgehogs with unresolvable urethral obstruction. [ABSTRACT FROM AUTHOR]

Competing Interests: None.

Background: Psoriasis is a chronic inflammatory disease that may affect the genitalia in up to 60% of patients. This is a significant concern to patients; however, they may be too embarrassed to report genital involvement or seek help for it spontaneously. Information on preferred language that would put patients more at ease discussing disease in sensitive areas is lacking., Objective: To address language as a barrier to care in patients with psoriasis by identifying preferred terminology when discussing genital involvement of the disease with physicians., Methods: A qualitative study was performed that consisted of one-on-one interviews with patients with psoriasis; thematic analysis was used to analyze the data., Results: Themes included (1) personal experience with genital psoriasis; (2) timespan between genital psoriasis symptom onset and diagnosis; (3) patient-provider communication; (4) patient-provider preference, and (5) patient terminology preference., Conclusion: Our study highlights providers' failure to ask psoriasis patients about genital involvement of the disease and variation in patient response on preferred language when discussing sensitive topics. Dermatologists may need to be cognizant of the patient's comfort level using verbal and nonverbal communication and tailor their approach to the individual., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Steven R. Feldman has received research, speaking and/or consulting support from Eli Lilly and Company, GlaxoSmithKline/Stiefel, AbbVie, Janssen, Alovtech, vTv Therapeutics, Bristol-Myers Squibb, Samsung, Pfizer, Boehringer Ingelheim, Amgen, Dermavant, Arcutis, Novartis, Novan, UCB, Helsinn, Sun Pharma, Almirall, Galderma, Leo Pharma, Mylan, Celgene, Ortho Dermatology, Menlo, Merck & Co, Qurient, Forte, Arena, Biocon, Accordant, Argenx, Sanofi, Regeneron, the National Biological Corporation, Caremark, Teladoc, Eurofins, Informa, UpToDate and the National Psoriasis Foundation. He is founder and part owner of Causa Research and holds stock in Sensal Health., (© The Author(s) 2023.)

Viral vaccines have traditionally protected against disease, but for viruses that establish latent infection, it is desirable for the vaccine to reduce infection to reduce latent infection and reactivation. While seroconversion has been used in clinical trials of herpes simplex virus (HSV) vaccines to measure protection from infection, this has not been modeled in animal infection systems. To measure the ability of a genital herpes vaccine candidate to protect against various aspects of infection, we established a non-lethal murine model of genital HSV-2 infection, an ELISA assay to measure antibodies specific for infected cell protein 8 (ICP8), and a very sensitive qPCR assay. Using these assays, we observed that immunization with HSV-2 dl 5-29 virus reduced disease, viral shedding, seroconversion, and latent infection by the HSV-2 challenge virus. Therefore, it may be feasible to obtain protection against genital disease, seroconversion and latent infection by immunization, even if sterilizing immunity is not achieved. [ABSTRACT FROM AUTHOR]

Background: Contagious Epididymitis (CE) due to Brucella ovis (B. ovis) is a contagious disease that impairs rams' fertility due to epididymis, testicle and accessory sexual gland alterations. An increased incidence of CE has been observed in South Eastern France ("PACA" region) since the Rev.1 vaccination against B. melitensis has been stopped in 2008. The objective of this study was to evaluate the relationship between the infection by B. ovis and the sexual function of rams. Two-hundred eighteen sexually-mature rams, from 11 seropositive flocks, were submitted to a clinical examination of the genital tract, a semen collection by electro-ejaculation for spermogram and culture, and a serological examination for anti-B. ovis antibodies by complement fixation test (CFT) and indirect ELISA (I-ELISA). The relationships between clinical, seminal, bacteriological and serological parameters were studied using the Fisher exact test and a logistic regression model (binomial logit). Results: B. ovis shedding in semen was significantly associated with seropositivity (CFT and I-ELISA; p < 0.001 and 0.01 respectively), genital tract alterations (p < 0.05) and poor semen quality (p < 0.001). Seropositive rams presented significantly more genital tract alterations (p < 0.001) and a poor seminal score (p < 0.001) than seronegative rams. Conclusions: Since semen culture is not routinely feasible in field conditions, a control plan of CE should be based, where Rev.1 vaccination is not possible, on both systematic clinical and serological examination of rams, followed by the culling of seropositive and/or genital tract alterations carrier rams. [ABSTRACT FROM AUTHOR]

Background: Vulvar diseases are common in the general population and have a negative impact on the quality of life., Objectives: To describe our experience as dermatologists in the management of vulvar dermatosis consultations., Methods: A retrospective observational study was conducted with patients who attended monographic vulvar consultations over a 5-year period. Clinical information was obtained from the patient's charts., Results: 148 women were studied. Their mean age was 43.24 years (standard deviation: 15.15 years), with ages ranging from 4 months to 80 years. 53.4% of patients took between 2 and 5 years to seek medical attention for the first time. The most frequent diagnosis was lichen sclerosus (41.9%), irritative eczema of the vulva (14.9%), and lichen simplex chronicus (10.1%). 83.8% reported anogenital itching, 66.2% pain, and 45.9% dyspareunia. The most frequently prescribed treatment was ultra-potent topical corticosteroids (clobetasol propionate; 41.2%). Patients with lichen sclerosus were significantly older than those who presented with any of the other diseases. No differences were found in terms of either the time of disease evolution or in symptom presentation., Study Limitations: Retrospective study. Vulvar diseases with an infectious cause are usually managed in primary care, therefore, were not included. All patients were recruited from a single private hospital which limits the comparisons with the public health system., Conclusions: Vulvar diseases frequently occur and are associated with high morbidity. It is essential to promote the development of specific vulvar consultations in hospitals. Specialties such as dermatology, gynecology, urology, or physiotherapy must be part of these units., (Copyright © 2022 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)

AIM: To determine the time taken for rams to develop antibodies toBrucella ovisin serum, shedB. ovisin semen and develop lesions of epididymitis following infection withB. ovis. METHODS: Fifteen 19-month-old rams were artificially infected withB. ovisby inoculation of infected semen onto the nasal and rectal mucus membranes (Day 0). Serum was collected from each ram at 2 to 8-day intervals and tested at commercial laboratories using a complement fixation test (CFT) and an ELISA. Cut-off values for the CFT were 0–4/4 negative; 1/8–3/8 suspicious and 4/8–4/128 positive, and for the ELISA were <10% negative; ≥10 to <50% suspicious and ≥50% positive. Selected serum samples were also tested using a gel diffusion test (GDT). At 7 to 8-day intervals semen was collected for bacterial culture and the scrotal contents were palpated to identify lesions of epididymitis. The study was terminated after 56 days. RESULTS: On Day 28B. oviswas isolated from the semen of one ram and by Day 49 it was isolated from the semen of 10 rams. All 10 rams had suspicious or positive ELISA or CFT titres by Day 36 and 56, respectively. The GDT results were all negative on Day 36 and in general did not become positive in individual rams until 7–28 days after semen shedding commenced. Epididymitis was detected in one ram on Day 36; by Day 56 eight rams had epididymitis detectable by scrotal palpation. CONCLUSIONS: TheB. ovisELISA test identified infected rams at an earlier stage than the CFT; this was at 19–36 days after exposure. Rams can begin sheddingB. ovisin semen as early as 28 days after exposure and lesions of epididymitis develop as early as 36 days after exposure. CLINICAL RELEVANCE: During a test and slaughter campaign for the control ofB. ovis, the most appropriate serological re-testing interval is likely to be around 28 days (4 weeks) using the ELISA with or without the CFT, although caution is required in interpretation of “suspicious” ELISA results. Following aB. ovisbreakdown, two negative CFT or ELISA tests 60 days apart are recommended to confirm freedom from infection, supporting current guidelines. [ABSTRACT FROM PUBLISHER]

Background: Lichen sclerosus (LS) and lichen planus (LP) are inflammatory diseases that demonstrate genital and extra-genital manifestations. Genital involvement may result in pruritus, sexual dysfunction, pain, and irritation. It is intuitive that the severity of symptoms may result in functional impairment and emotional distress, leading to a reduction in quality of life (QoL)., Objective: Investigate the current literature on the impact of genital LS and LP on QoL., Methods: A literature review was performed using PubMed and results were summarized. Articles published between 1994 and 2020 were screened and reviewed by both the authors., Results: These diseases have been assessed with dermatological assessments, such as the Skindex-29 and the Dermatology Life Quality Index, general health surveys such as the Short Form-12 questionnaire, and mental health instruments including the Beck Depression Inventory, and others; these instruments consistently demonstrate impaired QoL. It follows that treatment may reduce these symptoms. Interventions, such as photodynamic therapy, have demonstrated improvement in the depressive symptoms that impact QoL. Although both females and males experience a reduction in QoL related to these diseases, they experience the symptomatology differently. Through interviewing, male patients were more likely to report no symptoms compared with female patients, while female patients were also more likely to report worse QoL in the work-school domain of the Dermatology Life Quality Index as compared with male patients., Limitations: Few studies have addressed the effect of disease severity or treatment on QoL., Conclusions: Understanding how genital LS and LP contribute to reduced QoL for patients is critical for health care providers to better prioritize treatment strategies. Future prospective studies should investigate how QoL correlates with disease severity and response to treatment., Competing Interests: D.R.P. is a consultant for Biogen Inc. and clinical trials principal/sub investigator for Corbus Pharmaceuticals, Elorac, Inc., Eli Lilly and Company, Emerald Health Pharmaceuticals, Kadmon, Inc., Pfizer, Inc., and Soligenix, Inc., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Women’s Dermatologic Society.)

Objective To understand the left-behind women's reproductive tract infection (RTI) status and influencing factors in the northeast ecological conservation development area of Chongqing to perfect the epidemiological monitoring and management and provide a scientific basis for the left-behind women's RTI prevention and control. Methods A total of 360 left- behind women and non-left-behind women as the research subjects were randomly extracted from northeast ecological conserva­tion development area of Chongqing from October 2015 to August 2016. The general data, awareness situation of AIDS transmis­sion route, classification and composition of RTI pathogens and relation between RTI with age were performed the statistical anal­ysis by using the reproductive health related questionnaire and laboratory detection. Results Among 360 respondents, the de­tected cases included 8 cases of treponema pallidum infection, 28 cases of Chlamydia trachomatis infection,48 cases of Ureaplas -ma urealyticum infection, 16 cases of gonococcal infection, 16 cases of trichomonal infection and 28 cases of mycotic infection. The awareness rates of transmission through blood transfusion, injection transmission, sexual intercourse transmission, fetal trans­mission of pregnant women, and known AIDS transmission routes such as breast feeding and mosquito bite had no statistical dif­ference between left behind women and non-left-behind women (P>0.05) , while the awareness rate of transmission route of sharing meal at the same table in non-left-behind women was significantly higher than that in left-behind women, the difference was statis­tically significant (P<0.05 ) ; the RTI risk of sexual transmission except for AIDS and non-sexual transmission in left-behind women was significantly higher than that in non-left-behind women with statistically significant difference (P<0.05 ) , moreover mycoplasma infection was more evident; the RTI occurrence risk by sexual transmission and non-sexual transmission had statisti­cal difference between different ages of left-behind women and non-left-behind women (P<0.05 ) , moreover the RTI occurrence rate by sexual transmission was decreased with age increasing, while which by non-sexual transmission was increased with age increasing. Conclusion Strengthening the publicity and education of RTI prevention and treatment and related knowledge on left- behind women, and regular health screening and intervention are conducive to reduce the RTI risk in left-behind women. [ABSTRACT FROM AUTHOR]

The adaptation of dermatology for the genital area requires several modifications of standard therapy. This unique area produces issues of both psychological sensitivity and unique environmental factors of constant moisture, warmth, and friction. These issues become far more important when symptoms are chronic. Recognition of normal variants, the multifactorial nature of many genital symptoms, and the avoidance of creating secondary iatrogenic disease are all important. [ABSTRACT FROM AUTHOR]

Genital infections with Chlamydia trachomatis can lead to uterine and oviduct tissue damage in the female reproductive tract. Neutrophils are strongly associated with tissue damage during chlamydial infection, while an adaptive CD4 T cell response is necessary to combat infection. Activation of triggering receptor expressed on myeloid cells-1 (TREM-1) on neutrophils has previously been shown to induce and/or enhance degranulation synergistically with Toll-like receptor (TLR) signaling. Additionally, TREM-1 can promote neutrophil transepithelial migration. In this study, we sought to determine the contribution of TREM-1,3 to immunopathology in the female mouse genital tract during Chlamydia muridarum infection. Relative to control mice, trem1,3 -/- mice had no difference in chlamydial burden or duration of lower-genital-tract infection. We also observed a similar incidence of hydrosalpinx 45 days postinfection in trem1,3 -/- compared to wild-type (WT) mice. However, compared to WT mice, trem1,3 -/- mice developed significantly fewer hydrometra in uterine horns. Early in infection, trem1,3 -/- mice displayed a notable decrease in the number of uterine glands containing polymorphonuclear cells and uterine horn lumens had fewer neutrophils, with increased granulocyte colony-stimulating factor (G-CSF). trem1,3 -/- mice also had reduced erosion of the luminal epithelium. These data indicate that TREM-1,3 contributes to transepithelial neutrophil migration in the uterus and uterine glands, promoting the occurrence of hydrometra in infected mice.

A case of mansoni schistosomiasis causing peritoneal inflammation and chronic iliac pain is reported. The patient complained of iliac pain for 6 months. Physical examination and sonographic evaluation found a tumor in the left iliac fosse. A pseudocyst was removed from the pelvic region. The histopathology confirmed the diagnosis of S. mansoni. This is a rare case of S. mansoni in the pelvic cavity. [ABSTRACT FROM AUTHOR]

Herpes simplex virus type 2 (HSV-2) causes recurrent lesions in the anogenital area that may be transmitted through sexual encounters. Nucleoside analogs, such as acyclovir (ACV), are currently prescribed clinically to curb this infection. However, in some cases, reduced efficacy has been observed due to the emergence of resistance against these drugs. In our previous study, we reported the discovery of a novel anti-HSV-1 small molecule, BX795, which was originally used as an inhibitor of TANK-binding kinase 1 (TBK1). In this study, we report the antiviral efficacy of BX795 on HSV-2 infection in vaginal epithelial cells in vitro at 10 μM and in vivo at 50 μM. Additionally, through biochemical assays in vitro and histopathology in vivo , we show the tolerability of BX795 in vaginal epithelial cells at concentrations as high as 80 μM. Our investigations also revealed that the mechanism of action of BX795 antiviral activity stems from the reduction of viral protein translation via inhibition of protein kinase B phosphorylation. Finally, using a murine model of vaginal infection, we show that topical therapy using 50 μM BX795 is well tolerated and efficacious in controlling HSV-2 replication., (Copyright © 2020 American Society for Microbiology.)