Chronic Anogenital Ulcerations and Polymicrobial Pelvic Infections: About a Case

Genital ulceration is the loss of integrity of the mucous membranes (or genital skin) leaving the dermis uncovered and almost always accompanied by satellite lymphadenopathies. Beyond a month of evolution, it is said to be chronic. Sexually transmitted diseases are infections due to microbial agents among which parasites, bacteria, viruses and fungi that can be associated with each other to varying degrees. Sexually transmitted infections must be mentioned before any genital ulceration. Hence the interest of the case that we report of chronic anogenital ulcerations complicating a polymicrobial pelvic infection in a patient immunocompromised to HIV. The physical examination reveals a hypogastric sensitivity to deep palpation, the presence of a superinfected anogenital ulceration exposing the deep dermis covered with purulent serosities interesting the labia minora, the posterior vaginal fork, the anal region, the clitoris and an extension of the lesions to the gluteal fold is observed. We found a satellite lymphadenopathy in the right inguinal fold. The screening finds the HIV1 positive serology with a viral load of 28,000 copies, the herpes simplex 1&2 and Chlamydia trachomatis serologies were all positive. The genital samples are marked by the presence of bacterial vaginosis with Candida Albicans and Gardnerella Vaginalis, the presence of urogenital mycoplasmas of the Ureaplasma Urealyticum The pelvic ultrasound was in favor of a bilateral adnexitis. A protocol was put in place: the first step consisted of seat baths, antifungi and antibiotics administration: fluconazole 150 mg and tinidazole 2 g in single doses, then josamycin 1 g/24h in two doses per os for two weeks. The second stage consists of the administration of doxycycline 200 mg for 21 days, Aciclovir 500 mg for 10 days, and the administration of ARV (Tenofovir + Lamivudine + Dolutegravir) or one tablet daily. The evolution is marked by a progressive healing of the clitoris, the labia majora and labia minora, the posterior vaginal fork. In case of chronicity, a biopsy in search of a tumor process is not mandatory when there is a satisfactory response to treatment and good healing. The patient’s death two weeks after the beginning of ARV treatment, can be explained by a probable immune reconstitution syndrome.

Correlates of Anogenital Injuries in Adolescent Females

Objective: We sought to investigate correlates of anogenital injuries (AGIs) in adolescents. Methods: Our retrospective study included sexually assaulted female patients aged 12 to 17 reporting attempted or completed vaginal or anal penetration between 2002 and 2011. Forensic nurses performed anogenital examinations using colposcopy, digital macrovisualization, and toluidine blue dye application. We reviewed case files for AGIs and demographic and sexual assault characteristics. Results: Of the 1961 sexual assault examinations that met our inclusion criteria, 59.6% displayed AGIs. Our logistic regression model using 1752 examinations found the following variables associated with less injury: intercourse within 5 days prior to assault (OR 0.72, 95% CI = 0.55 to 0.95);post-coital interval of 49-72 (OR 0.50, 95% CI = 0.36 to 0.71), 73-96 (OR 0.41, 95% CI = 0.25 to 0.68), and 97-120 hours (OR 0.26, 95% CI = 0.13 to 0.51). Only lack of prior sexual experience was associated with increased injury (OR 2.01, 95% CI = 1.58 to 2.55). Conclusions: In our adolescent patient population, examination findings of AGIs correlate with variables related to time from assault and prior sexual experience.

Anogenital Condyloma: Epidemiological, Clinical, Therapeutic and Evolutionary Aspects of 74 Cases in Benin

The aim of this study was to study the epidemiological, clinical, therapeutic and evolutionary aspects of anogenital warts in Benin. A retrospective cohort study was conducted over a 4-year period from January 1st, 2013 to December 31st, 2016 at the Dermatology-Venerology Clinic of Cotonou. A total of 74 patients, including 67 men and middle aged 35.1 ± 10.3 years, were received for anogenital condyloma during the study period, accounting for 2.1% of the total and 28.2% of patients were received for sexually transmitted infection. The most common clinical form was acuminated condyloma (61 cases;82.4%). HIV serology was positive in 12 patients (16.2%). Therapeutically, the use of electrocoagulation was systematic in 80% of cases. The evolvement is noticeable when 37% of the cases were recidivated and the rate of loss of sight after the first consultation was 60.8%. Early diagnosis and improvement of the technical platform will help to improve the quality of care for these patients.

Cutaneous Crohn’s Disease and Anogenital Granulomatosis with Crohn’s Disease: Many Names for the Same Clinical Entity

Anogenital granulomatosis (AGG) is a rare chronic idiopathic disorder presenting as a painless swelling of the vulva, labia, penis, and/or anogenital area. Some AGG cases have been diagnosed along with Crohn’s disease (CD). We report a case of AGG that led to diagnosis of underlying CD, namely Cutaneous Crohn’s disease (CCD). We guess that CCD appeared in the anogenital region is equal to AGG with CD.

Seasonal and reproductive variation in chemical constituents of scent signals in wild giant pandas

Seasonally reproducing animals show many behavioral and physiological changes during the mating period, including increased signaling for intrasexual competition and mate attraction. We collected 102 anogenital gland secretions(AGS) from marking trees in Foping Nature Reserve, and used gas chromatography mass spectrometry to analyze these chemical composition. Of these marks, all but one were from males, confirmed with DNA analysis. We found that several chemical constituents, especially volatile compounds, were present only during the mating season and that the relative abundance of many compounds changed as a function of breeding season, whereas nonvolatile compounds were lower in the mating season. This seasonal variation in chemical composition of AGS most likely plays an important role in governing giant panda reproduction, including mate location, attraction, and male-male competition. The chemical properties of many of these putative chemosignals—such as volatility and longevity—are suggestive of these roles, and undoubtedly contribute to successful reproduction for this species with a characteristically sophisticated chemical communication system. We also found a number of important differences between the chemical constituents of AGS from wild pandas and those found in previous studies with captive pandas, suggesting that inappropriate chemosignal composition may contribute to poor reproductive success in captive breeding programs.

High-risk HPVs, microbiota and epithelial carcinogenesis: state of the art and research contribution of in vitro 3D models

Persistent high-risk human papillomavirus (HR-HPV) infection is associated with anogenital and head & neck squamous epithelial (HNSCC) tumors, which altogether cause about 550,000 new cases every year. Several evidences suggest that the microbiota could have a role on the inflammatory, epithelial mesenchymal transition and tumorigenesis processes promoted by HR-HPV infection, yet the mechanisms involved remain to be clarified. In this review we report the state of the art on this topic and on the most promising in vitro developed models for studying the host-pathogen interactions. Using MEDLINE, several terms were searched and combined to select the most pertinent papers. The investigation was limited to the international indexed articles published in PubMed in the last 10 years. This review reports the latest knowledge in the field of the microbial-associated anogenital tumors and HNSCC. In addition, we also discuss the in vitro epithelial culture systems that reproduce the pathophysiological features of the tumoral microenvironment and the in vivo response to microbial agents, thus representing a useful tool for analyzing at cellular and molecular levels the role played by infective agents in tumorigenesis.