The Experts below are selected from a list of 78 Experts worldwide ranked by ideXlab platform
John B. Pope - One of the best experts on this subject based on the ideXlab platform.
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Noncervical human papillomavirus genital infections.
American family physician, 1995Co-Authors: Michael B. Harper, Barksdale W, John B. PopeAbstract:The incidence of human papillomavirus infection is increasing. More than 60 types of human papillomavirus have been isolated; some types are known to have malignant potential. Differential diagnosis of the lesions includes Condyloma latum, seborrheic keratoses, nevi, pearly penile papules and neoplasms. The goal in treating noncervical human papillomavirus infection is the elimination of lesions; eradication of the virus is not yet possible. Current forms of treatment include cryotherapy, podophyllum resin, podophilox, trichloroacetic acid, laser ablation, loop electrosurgical excision procedure (LEEP), fluorouracil and alpha interferon. Success in treating Condyloma may be increased if the area is first soaked with 5 percent acetic acid to more clearly show the extent of the local infection. Recurrence is a problem no matter what form of therapy is used.
Jennifer Frank - One of the best experts on this subject based on the ideXlab platform.
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Diagnosis and management of syphilis.
American family physician, 2003Co-Authors: David L. Brown, Jennifer FrankAbstract:Syphilis is a sexually transmitted disease with varied and often subtle clinical manifestations. Primary syphilis typically presents as a solitary, painless chancre, whereas secondary syphilis can have a wide variety of symptoms, especially fever, lymphadenopathy, rash, and genital or perineal Condyloma latum. In latent syphilis, all clinical manifestations subside, and infection is apparent only on serologic testing. Late or tertiary syphilis can manifest years after infection as gummatous disease, cardiovascular disease, or central nervous system involvement. Neurosyphilis can develop in any stage of syphilis. The diagnosis of syphilis may involve dark-field microscopy of skin lesions but most often requires screening with a nontreponemal test and confirmation with a treponemal-specific test. Parenterally administered penicillin G is considered first-line therapy for all stages of syphilis. Alternative regimens for nonpregnant patients with no evidence of central nervous system involvement include doxycycline, tetracycline, ceftriaxone, and azithromycin. In pregnant women and patients with neurosyphilis, penicillin remains the only effective treatment option; if these patients are allergic to penicillin, desensitization is required before treatment is initiated. Once the diagnosis of syphilis is confirmed, quantitative nontreponemal test titers should be obtained. These titers should decline fourfold within six months after treatment of primary or secondary syphilis and within 12 to 24 months after treatment of latent or late syphilis. Serial cerebrospinal fluid examinations are necessary to ensure adequate treatment of neurosyphilis.
Michael B. Harper - One of the best experts on this subject based on the ideXlab platform.
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Noncervical human papillomavirus genital infections.
American family physician, 1995Co-Authors: Michael B. Harper, Barksdale W, John B. PopeAbstract:The incidence of human papillomavirus infection is increasing. More than 60 types of human papillomavirus have been isolated; some types are known to have malignant potential. Differential diagnosis of the lesions includes Condyloma latum, seborrheic keratoses, nevi, pearly penile papules and neoplasms. The goal in treating noncervical human papillomavirus infection is the elimination of lesions; eradication of the virus is not yet possible. Current forms of treatment include cryotherapy, podophyllum resin, podophilox, trichloroacetic acid, laser ablation, loop electrosurgical excision procedure (LEEP), fluorouracil and alpha interferon. Success in treating Condyloma may be increased if the area is first soaked with 5 percent acetic acid to more clearly show the extent of the local infection. Recurrence is a problem no matter what form of therapy is used.
Peña García, María Juliana - One of the best experts on this subject based on the ideXlab platform.
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Manifestaciones dermatológicas de la sífilis
'Universidad Industrial de Santander', 2011Co-Authors: Forero Laguado Nancy, Peña García, María JulianaAbstract:ResumenLa sífilis es una enfermedad de transmisión sexual causada por la espiroqueta Treponema pallidum. Aproximadamente sepresentan 10 6 millones de nuevos casos por año a nivel mundial y en nuestro país 32 casos por cada 100 000 personas. Lainfección se clasifica en sífilis primaria, secundaria, latente y terciaria. La sífilis primaria se caracteriza por una úlceraindolora y dura (chancro), que aparece en genitales o en cualquier otra área de contacto, con resolución de dos a seissemanas con o sin tratamiento. La sífilis secundaria se manifiesta de seis semanas a seis meses después de la resolucióndel chancro primario; esta fase se presenta con varias manifestaciones sistémicas y dermatológicas tales como: el clásicoexantema maculopapular en palmas y plantas, la alopecia en parches, los parches mucosos y el condiloma lata. La sífilislatente se define como el periodo después de la infección del T. pallidum en los pacientes seroreactivos, en ausenciade manifestaciones clínicas. Y la sífilis terciaria, la cual puede presentarse como neurosífilis (paresia, tabes dorsal),sífilis cardiovascular (aneurisma aórtico) o goma (infiltrado de monocitos y destrucción tisular en cualquier órgano).Para su diagnóstico se usan inicialmente pruebas no treponémicas como el VDRL y el RPR, pero al ser inespecíficaspueden generar falsos positivos con diversas enfermedades agudas o crónicas, por esta razón se confirman con pruebastreponémicas como el FTA-ABS y la MHA-TP. El manejo es principalmente con Penicilina, en casos de alergia se usatetraciclina o doxiciclina, y ceftriaxona en casos de neurosífilis. El objetivo de este artículo es el enfoque en otroshallazgos dermatológicos diferentes al chancro sifilítico o a las úlceras que caracterizan la patología; se hace énfasisen mostrar cómo estos hallazgos, en ocasiones sutiles, pueden llevar al diagnóstico de las etapas avanzadas y que conmucha frecuencia se confunden con otras dermatosis o enfermedades sistémicas, proporcionando manejos erróneos queconllevan a la progresión de la verdadera enfermedad. De igual forma, se hace una revisión acerca de la actualidad sobrelos últimos hallazgos en el diagnóstico y tratamiento, asi como el panorama de la enfermedad en nuestro país. (MÉD.UIS. 2011;24(2):203-13).Palabras clave: Sífilis cutánea. Sífilis latente. Treponema pallidum. Serodiagnóstico de la sífilis.SummaryDermatologic manifestations of syphilisSyphilis is a sexual transmitted disease caused by the spirochete Treponema pallidum. Aproximately 10.6 millions of new cases a yearappeared worldwide and in our country 32 cases every 100 000 people. The infection is classified as primary, secondary, latent andtertiary Syphilis. Primary syphilis is characterized by painless and hard ulcer (chancre) that appears in genitals or any other contactarea with a resolution from tow to six weeks with or without treatment. Secondary syphilis is manifested from six weeks to six monthsafter the resolution of primary chancre; this stage appeared with several systemic and dermatologic manifestations such as the typicalmaculopapular rash in palms and soles, alopecia in patches, mucous patches and Condyloma latum. Latent syphilis is defined as the periodafter T. pallidum infection in seroreactive patients, in absence of clinical manifestations. And tertiary syphilis which may be presented asneurosyphilis, (paresis, tabes dorsalis), cardiovascular syphilis (aortic aneurysm) or gumma (monocytes infiltration and tissue destructionon any organ). Initially nontreponemal tests like the VDRL and the RPR are used for its diagnosis but when they are not specific, they maygenerate false positive reactions with several acute and chronic diseases, for that reason, they are confirmed with treponemal tests likethe FTA-ABS ant the MHA-TP. The treatment is with penicillin, principally, or doxicycline and tetracicline in allergic cases, and ceftriaxonein neurosyphilis cases. The objetive of this article is the approach in others dermatologic findings different to the syphilitic chancre, orthe ulcer that is typical of the pathology; emphasis is placed on show how these findings, in some cases subtle, can lead the diagnosisof the advanced stages and with frequency are confused with other dermatosis or systemis diseases, giving mishandling that lead to theprogression of the real problem. Similary is reviewed about the update in diagnosis and treatment, as well as the outlook of the diseasein our country. (MÉD.UIS. 2011;24(2):203-13).Key words: Syphilis cutaneous. Lantent syphilis. Treponema pallium. Syphilis serodiagnosis
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Manifestaciones dermatológicas de la sífilis
'Universidad Industrial de Santander', 2011Co-Authors: Forero Laguado Nancy, Peña García, María JulianaAbstract:Syphilis is a sexual transmitted disease caused by the spirochete Treponema pallidum. Aproximately 10.6 millions of new cases a year appeared worldwide and in our country 32 cases every 100 000 people. The infection is classified as primary, secondary, latent and tertiary Syphilis. Primary syphilis is characterized by painless and hard ulcer (chancre) that appears in genitals or any other contact area with a resolution from tow to six weeks with or without treatment. Secondary syphilis is manifested from six weeks to six months after the resolution of primary chancre; this stage appeared with several systemic and dermatologic manifestations such as the typical maculopapular rash in palms and soles, alopecia in patches, mucous patches and Condyloma latum. Latent syphilis is defined as the period after T. pallidum infection in seroreactive patients, in absence of clinical manifestations. And tertiary syphilis which may be presented as neurosyphilis, (paresis, tabes dorsalis), cardiovascular syphilis (aortic aneurysm) or gumma (monocytes infiltration and tissue destruction on any organ). Initially nontreponemal tests like the VDRL and the RPR are used for its diagnosis but when they are not specific, they may generate false positive reactions with several acute and chronic diseases, for that reason, they are confirmed with treponemal tests like the FTA-ABS ant the MHA-TP. The treatment is with penicillin, principally, or doxicycline and tetracicline in allergic cases, and ceftriaxone in neurosyphilis cases. The objetive of this article is the approach in others dermatologic findings different to the syphilitic chancre, or the ulcer that is typical of the pathology; emphasis is placed on show how these findings, in some cases subtle, can lead the diagnosis of the advanced stages and with frequency are confused with other dermatosis or systemis diseases, giving mishandling that lead to the progression of the real problem. Similary is reviewed about the update in diagnosis and treatment, as well as the outlook of the disease in our country. (MÉD.UIS. 2011;24(2):203-13).La sífilis es una enfermedad de transmisión sexual causada por la espiroqueta Treponema pallidum. Aproximadamente se presentan 10 6 millones de nuevos casos por año a nivel mundial y en nuestro país 32 casos por cada 100 000 personas. La infección se clasifica en sífilis primaria, secundaria, latente y terciaria. La sífilis primaria se caracteriza por una úlcera indolora y dura (chancro), que aparece en genitales o en cualquier otra área de contacto, con resolución de dos a seis semanas con o sin tratamiento. La sífilis secundaria se manifiesta de seis semanas a seis meses después de la resolución del chancro primario; esta fase se presenta con varias manifestaciones sistémicas y dermatológicas tales como: el clásico exantema maculopapular en palmas y plantas, la alopecia en parches, los parches mucosos y el condiloma lata. La sífilis latente se define como el periodo después de la infección del T. pallidum en los pacientes seroreactivos, en ausencia de manifestaciones clínicas. Y la sífilis terciaria, la cual puede presentarse como neurosífilis (paresia, tabes dorsal), sífilis cardiovascular (aneurisma aórtico) o goma (infiltrado de monocitos y destrucción tisular en cualquier órgano). Para su diagnóstico se usan inicialmente pruebas no treponémicas como el VDRL y el RPR, pero al ser inespecíficas pueden generar falsos positivos con diversas enfermedades agudas o crónicas, por esta razón se confirman con pruebas treponémicas como el FTA-ABS y la MHA-TP. El manejo es principalmente con Penicilina, en casos de alergia se usa tetraciclina o doxiciclina, y ceftriaxona en casos de neurosífilis. El objetivo de este artículo es el enfoque en otros hallazgos dermatológicos diferentes al chancro sifilítico o a las úlceras que caracterizan la patología; se hace énfasis en mostrar cómo estos hallazgos, en ocasiones sutiles, pueden llevar al diagnóstico de las etapas avanzadas y que con mucha frecuencia se confunden con otras dermatosis o enfermedades sistémicas, proporcionando manejos erróneos que conllevan a la progresión de la verdadera enfermedad. De igual forma, se hace una revisión acerca de la actualidad sobre los últimos hallazgos en el diagnóstico y tratamiento, asi como el panorama de la enfermedad en nuestro país. (MÉD. UIS. 2011;24(2):203-13)
Du Xiao-hong - One of the best experts on this subject based on the ideXlab platform.
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Early Stage Syphilis: Clinical and Pathological Analysis of 1200 Cases
Chinese Journal of Nosocomiology, 2006Co-Authors: Du Xiao-hongAbstract:OBJECTIVE To study the clinic feature and cause of misdiagnosis of early stage syphilis and evaluate the significance of histopathology in the diagnosis of the disease. METHODS Totally 1 200 early syphilis cases were analyzed.The serologic test for syphilis was performed.Thirty five of them were performed with histopathological examination. RESULTS The primary syphilis was found to be commonly misdiagnosed as chancroid,genital herpes,scabies nodules and ulcus vulvae acutum.For secondary syphilis,macular syphilide and maculopapular syphilide were easily misdiagnosed as pityriasis rosea or dermatitis.The papulosquamous syphilide was commonly misdiagnosed as psoriasis.The Condyloma latum was commonly misdiagnosed as Condyloma acuminatum. CONCLUSIONS The serologic test is important in diagnosis of primary syphilis.The histopathologic test plays a role in diagnosis of primary syphilis,Condyloma latum and papulosquamous syphilide,but of limited value in diagnosis of macular syphilide.