A Clinical study of Pruritus Vulvae among Sexually Transmitted Infections Clinic Attendees in a Tertiary Care Hospital

Soundharyaa Moorthi, S (2020) A Clinical study of Pruritus Vulvae among Sexually Transmitted Infections Clinic Attendees in a Tertiary Care Hospital. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

INTRODUCTION: Pruritus vulvae are the most distressing condition among females of all age groups. Homeostatis of vagina is maintained by lactobacillus which is an integral part of the ecosystem. Many physiological and pathological conditions are responsible for damaging the acid mantle in the perineal area. Geriatric patients are more distressed with this condition as those women have already gone through menopause and its associated physical, emotional and hormonal changes. Infectious causes include vulvovaginal candidiasis, trichomonas vaginalis, bacterial vaginosis, genital warts, dermatophytosis, helminthic infections. Non-infectious causes like lichen simplex chronicus, lichen sclerosus et atrophicans, lichen planus, contact dermatitis, atopic dermatitis, atrophic vulvovaginitis, scabies, eczema, genital psoriasis, vesicobullous disorders. Systemic diseases like diabetes mellitus, chronic renal insufficiency, cholestasis, polycythemia vera, lymphomas, malignancies, may also cause vulvar pruritus. Even psychogenic and neurogenic causes are being more troublesome to the patient at the present scenario. AIM OF THE STUDY: 1. To study the clinical, etiological and histopathological aspects of pruritus vulvae among patients attending sexually transmitted infections clinic. 2. To study the various etiologies of pruritus vulvae. 3. To confirm the diagnosis by means of laboratory investigations. 4. To emphasize the patients with vulvovaginal hygiene and care. 5. To assess the associated co-morbid conditions. MATERIALS& METHODS: Our study included 225 females with complaints of vulvar itching during period of January 2018-June 2019. Clinical examinations include inspection of labia majora, labia minora and mons pubis for any primary and secondary skin lesions pertaining to vulval pruritus. Examination by using Cusco’s speculum were done and the nature and colour of discharge were noted. Vaginal discharge was obtained using cotton tipped swabs for wet mount, KOH mount and grams stain. Routine blood investigations like random blood sugar, renal function tests, liver function tests, peripheral smear, urine for albumin, sugar and deposits and motion for ova cyst were done for all attendees. CONCLUSION: The following are the implications derived from this prospective study on clinical study of pruritus vulvae among STI clinic attendees more than 12 years of age over a period of one and a half year. ◈ The most common age group encountered in our study was 40-64 years (53.3%) followed by 20-39 years of (36.9%). ◈ Low socioeconomic status and low education are more prone for acquiring pruritus vulvae. ◈ Increased prevalence was seen among married women (85.3%). ◈ Increased prevalence with sexually active people with last contact being less one-month duration (56.4%). ◈ Proper and regular condom usage was seen in 40.4% of females and the remaining 59.6% females with unprotected sexual intercourse are more prone for acquiring STI causing pruritus vulvae. ◈ Among 225 cases of pruritus vulvae, pruritus was associated with discharge in 40.4% and burning sensation in 3.5%. ◈ The most common aetiology observed was VVC with clinical presentation of curdy white discharge in 57.3% females. ◈ In the study, most common infective aetiology encountered with pruritus vulvae was VVC (57.3%). ◈ The next common infective aetiology was intertrigo (19.1%) followed by bacterial vaginosis (3.6%). ◈ The most common non-infective aetiology was lichen sclerosus et atrophicus (10.2%), lichen simplex chronicus and lymphangioma circumscriptum in 0.4% each. ◈ Each case was clinically diagnosed and confirmed by various standard laboratory methods like KOH examination, wet mount, gram staining, Tzanck smear and culture for growth of candida species in SDA and CHROM agar. ◈ Diabetes mellitus was also associated with the diagnosis of pruritus vulvae in 12% of females in the study. ◈ Prevalence of HIV among the study group was only 8%.

Item Type: Thesis (Masters)
Additional Information: 201730255
Uncontrolled Keywords: pruritus vulvae, Vulvovaginal candidiasis (VVC), Lichen sclerosus et atrophicus (LSA).
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Feb 2021 03:18
Last Modified: 05 Feb 2021 14:51
URI: http://repository-tnmgrmu.ac.in/id/eprint/13885

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