PubMed Health⌕ Search

Biomedical subjects

J Yell

Publications and source records attributed to J Yell.

10 recordsLinked to original sources
PubMed2004

Isolated vulval splitting--is this normal or pathological?

Vulval splitting may be seen in association with clinically apparent dermatological disease but occasionally occurs in patients presenting with dyspareunia only. These patients usually have normal-looking vulvas on examination, apart from splitting. They are usually diagnosed as vulval vestibulitis. We have biopsied several patients with isolated vulval splitting with surprising results. Between the months of October 2000 and April 2002, 310 new patients were seen in the vulval clinic at Hope Hospital, which is a tertiary referral centre. Among these were nine cases of isolated vulval splitting, eight of which had histological features of dermatological disease on vulval biopsies. There were three cases of lichen planus, three with chronic dermatitis and two with candidiasis.

Adult↗
PubMed2002

Topical photodynamic therapy in disseminated superficial actinic porokeratosis.

Photodynamic therapy (PDT) has been reported to be useful in treating certain nonmelanoma skin cancers and a variety of benign skin conditions. We examined whether PDT might be effective in the treatment of disseminated superficial actinic porokeratosis. Three patients with classical disseminated superficial actinic porokeratosis had a small test area treated with topical aminolaevulinic acid PDT. Following the first treatment, the disorder cleared in the test area in one patient, but failed to respond in the other two patients. After subsequent treatment, the initial benefit seen in the first patient was not sustained, and no response was seen in the second patient, while the third patient was not retreated due to hyperpigmentation induced by the procedure. The results obtained in this small case series suggest that topical PDT is not a promising treatment for disseminated superficial actinic porokeratosis.

Administration, Cutaneous↗
PubMed1998

Managing vulvar lichen sclerosus in U.K. genitourinary medicine clinics.

OBJECTIVE: To survey genitourinary physicians in the United Kingdom on their approaches to the management of vulvar lichen sclerosus. STUDY DESIGN: Questionnaire survey of United Kingdom genitourinary consultants. RESULTS: Seventy-one percent of genitourinary physicians biopsy vulvar lichen sclerosus. For treatment, 78% of clinicians use a high-grade topical corticosteroid, such as 0.05% clobetasol propionate. Topical sex steroids are used by a minority of clinicians. Cases are followed by 80% of respondents. Having made the diagnosis of this condition, 30% of respondents refer the case to either a dermatologist or gynecologist for further management. Fifty-two percent refer only after treatment failure. CONCLUSION: Genitourinary physicians in the United Kingdom see and manage cases of vulvar lichen sclerosus in genitourinary medicine clinics. However, a majority of clinicians refer these cases at some stage. A coordinated and multispecialty approach between genitourinary physicians, dermatologists and gynecologists would provide coherent management of vulvar lichen sclerosus.

Administration, Topical↗
PubMed1995

The association between lichen sclerosus and antigens of the HLA system.

Although frequently linked clinically with autoimmune disease, no immunogenetic basis for lichen sclerosus has ever been established. In this study, we examined in detail the HLA antigens of 84 patients with histologically proven disease, compared with 357 controls. Patients with lichen sclerosus did not have the expected HLA A1, B8, DR3, DQ2 autoimmune profile. Instead, DQ7 was present in 39 of 78 (50%) of patients compared with 89 (25%) controls (P < 0.001). In addition, 61 of 78 patients (78%) had either DQ7, DQ8 or DQ9 antigens, or a combination of these, compared with 142 (40%) controls (P < 0.01). Raised levels of DQ7 correspond to a glutamic acid residue at position 45 of the DQB1 locus. Proline amino acids at position 55 of this DQB1 locus could explain the raised levels of DQ7, 8 and 9, and exert a secondary effect. There is preliminary evidence that the immunogenetic profile of patients with this disease may affect disease expression with regard to site and extent of involvement.

Adolescent↗