Vulvar elephantiasis
Introduction
Introduction to vulvar elephantiasis Vulvar elephantiasis is a disease caused by filarial, syphilitic or tuberculosis. Lesions often involve the lower limbs and the inguinal lymphatic system, causing the vulva skin to be localized or diffusely enlarged, thickened, tough, and shaped like a skin, hence the name. basic knowledge The proportion of illness: 0.032% Susceptible people: women Mode of infection: non-infectious Complications: headache
Cause
Vulvar elephantiasis
(1) Causes of the disease
After the vulva is infected with the filaria, the female continuously produces microfilariae in the lymphatic vessels of the human body, which parasitizes the lymphatic system to cause lymphangitis, obstruction of the lymphatic vessels, and finally the obstructed lymphatic vessels are varicose, and the skin nutrition disorder of the administrated area is affected. Chronic thickening, the formation of vulvar elephantiasis.
In addition, repeated episodes of vulvar cellulitis, chronic inflammation of the vulva, such as tuberculosis, syphilis, can cause connective tissue fibrosis, venous and lymphatic drainage blocked, and finally lead to vulvar elephantiasis.
(two) pathogenesis
1. Elephantiasis caused by filariasis
After mosquito bites, the infected larvae (microfilariae) can invade the human body through the wound, and then develop into adult insects in the lymphatic system. The toxins and metabolites secreted by the adult worms affect the lymphoid tissues of the genitourinary system, causing chyle hematuria and vulvar elephantiasis. In recent years, many scholars at home and abroad have confirmed by lymphatic angiography that the filarial elephantiasis is due to lymphatic varices, and the lymphatic circulation dynamics has undergone severe pathophysiological changes, rather than mechanical occlusion.
2. Elephantiasis caused by syphilis
More common in advanced syphilis, is the result of the body's more sensitive response to Treponema pallidum, resulting in inflammatory granuloma in the vulva tissue.
3. Tuberculosis caused by tuberculosis
When tuberculosis spreads through the lymphatic system or spreads directly from the adjacent lesions to the external pubic skin, it produces a tuberculous granuloma of the vulva and forms a fusion nodule.
Prevention
Vulvar elephant skin prevention
We should pay attention to prevention, do anti-mosquito and anti-mosquito work, eliminate vector; actively control syphilis, tuberculosis, vulvar cellulitis and various chronic inflammation to prevent the occurrence of elephantiasis.
Complication
Vulvar elephantiasis complications Complications
Combined infection, acute phase may have chills, high fever, headache and other systemic symptoms.
Symptom
Vulvar elephant skin swelling symptoms Common symptoms Itching vulva skin swelling clitoris hypertrophy difficulties chronic ulcers skin hypertrophy nutritional disorders secondary infections restless
The skin of the vulva (the clitoris, the labia majora) is limited or diffuse thickening, the clitoris is hypertrophy, the surface is rough, and it can be sausage-shaped, round or breast-shaped, and can be uneven, nodular, braided or papillary. The skin color can be changed to light brown, purple red, accompanied by desquamation, easy secondary infection, severe rubber disease on one side or the entire vulva swollen, sometimes shaped like a tumor, hanging between the two strands.
Due to the hypertrophy and swelling of the vulva skin, the patient is restless, difficulty in urinary and bladder, and affects sexual life. Due to the obstruction of veins and lymphatic drainage, skin dystrophy can cause itching. After scratching, it is easy to cause secondary infection, ulceration and pain. There are secretions, etc., and some even occur chronic ulcers, long-term unhealed, lymphangitis constant monthly acute episode 1 time, each episode 1 to 2 days, a few up to 10 days.
Examine
Examination of vulvar elephantiasis
Filariasis
Blood microfilament young: from 9:00 to 2 am, take 3 drops of earlobe blood on the clean glass, apply 2×3 thick blood film, dry hemolysis, staining, microscopic examination, body fluid examination microfilaria It can be directly smeared with lymph and stained for microscopic examination.
2. Syphilis
Dark-field microscopy: finding a typical and characteristic movement of Treponema pallidum is a positive result, has a diagnostic value, is also feasible treponema pallidum antigen test, TPHA, TPPA, FFA-ABS test is a confirmed test, after infection with syphilis Positive.
Tuberculosis
Tuberculin test: strong positive indicates that there are still active lesions. If it is negative, it means that there is no M. tuberculosis infection. Take local acid secretion smear for acid-fast staining to find tuberculosis or local secretion culture. Tuberculosis.
No special performance.
Diagnosis
Diagnosis and differentiation of vulvar elephantiasis
diagnosis
According to the clues provided by the history of epidemiology such as filariasis, there are clinical manifestations and test tests such as a history of unclean sex or a history of exposure to tuberculosis, and the diagnosis can basically be established.
Differential diagnosis
Vulvar varicose veins
Usually only see the subcutaneous vein, but due to long standing or in the third trimester of pregnancy, the venous bulge such as scorpion-like curvature, due to circulatory disorders, long-term expansion of blood vessels, can make one or both sides of the labia swelling, affecting the first exposed part of the fetus, childbirth If the varicose veins are severe, care should be taken to prevent rupture and infection.
2. Vulvar hemangioma
It is a congenital vascular structural abnormality, not a true tumor. It has various forms. It can become small or even disappear when acupressure, and it can be restored to its original state after relaxation. On the surface of some hemangiomas, varicose veins or local skin color are seen to be purple, and spongy vessels The shape of the tumor is irregular, and it can be lobulated, with a wide range of lesions, which can affect the perineum, vagina and anus. The position of the tumor is generally deep, the appearance is dark purple, and the color is faded when pressed, and sometimes it can affect the first exposed part of the fetus.
