Browsing by Author "Rivera, Sydney"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Dermatographism with vulvar symptoms
    (Elsevier, 2021-05-05) Rivera, Sydney; Mirowski, Ginat W.; Dermatology, School of Medicine
    Dermatographism (DG) is characterized by a localized, inducible, wheal-and-flare response along the distribution of mechanical pressure. We report an illustrative case of DG with vulvar symptoms (DG-VS) and review the literature on this rarely recognized but easily treated etiology of vulvar complaints. A 35-year-old woman presented with a 1-year history of vulvar pruritus unresponsive to antifungal, antibacterial, and steroid treatments. A prior punch biopsy was nondiagnostic. Vulvar examination revealed normal architecture and no cutaneous abnormalities. She was markedly dermatographic with a scratch test. DG-VS was diagnosed. The patient achieved complete symptomatic control on low-dose hydroxyzine. She maintains excellent control at 3.5 years. In the literature, a typical patient with DG-VS is of reproductive age, with several years' history of vulvar symptoms (itching, burning, pain, or swelling) and repeated empiric treatment for infectious/inflammatory etiologies. Exacerbation with sexual activity, menstruation, or wearing tight clothing is characteristic and supports the role of mechanical pressure in inducing focal symptoms. Dermatologic changes to the vulvar skin are rarely noted. DG-VS is diagnosed based on clinical findings, symptom patterns, and a positive scratch test and is treated with antihistamines. DG-VS remains absent from current vulvar disease guidelines. In the complex world of vulvar pain and itch, an etiology so easily screened for and readily treated warrants consideration.
  • Thumbnail Image
    Item
    Genital Self-Image, Sexual Function, and Quality of Life Among Individuals with Vulvar and Non-Vulvar Inflammatory Dermatoses
    (Springer, 2022) Rivera, Sydney; Flood, Anna; Dykstra, Chandler; Herbenick, Debby; DeMaria, Andrea L.; Medicine, School of Medicine
    Vulvar inflammatory dermatoses (VID; e.g., lichen sclerosus, lichen planus, vulvar dermatitis) can significantly impact sexual function. Both vulvar and non-vulvar inflammatory dermatoses (NVID; i.e., skin conditions not impacting vulvar skin, such as non-genital psoriasis and eczema/dermatitis) have yet to be fully characterized with regard to impact on genital self-image. A 20-min web-based survey was distributed September-November 2020 through social media ads, support groups, and online research recruitment services. Individuals in the USA over age 18 who were assigned female at birth and self-reported having been diagnosed with an inflammatory dermatosis were eligible. The primary outcome was the Female Genital Self-Image Scale (FGSIS). Secondary outcomes included the Female Sexual Function Index (FSFI), the Skindex-16 (a skin-related quality of life measure), the PROMIS Global-10 (assessing global physical/mental health), and sexual behavior histories. Participants (n = 348) reported mean age of 43.1 ± 15.5 (range = 19-81). Nearly one-third (n = 101; 29.0%) reported VID, 173 (50%) had NVID, and 74 (21%) experienced both vulvar and non-vulvar symptoms; they were analyzed as part of the VID group. The mean FGSIS score among participants with VID was 16.9 ± 4.1 and was significantly (p < .01) lower than that of participants with NVID (M = 21.2 ± 4.3), indicating lower genital self-image. Mental health (as measured by PROMIS-Global 10) was also impaired in VID. Rates of sexual dysfunction were high in both groups (> 60%). Findings suggest that in VID, lower genital self-image is correlated with poorer sexual function, quality of life, and global physical and mental health. Additional recommendations for VID management are proposed.
  • Thumbnail Image
    Item
    Healthcare worker knowledge and opinion regarding intimate partner violence screening in an academic dermatology clinic: a survey study
    (Wolters Kluwer, 2022-08-01) Carr, Christian L.; Rivera, Sydney; Jetelina, Katelyn K.; Mauskar, Melissa; Medicine, School of Medicine
  • Thumbnail Image
    Item
    Hydrocolloid dressing versus conventional wound care after dermatologic surgery
    (Elsevier, 2021-12-21) Holmes, Samantha P.; Rivera, Sydney; Hooper, Perry B.; Slaven, James E.; Que, Syril Keena T.; Medicine, School of Medicine
    Background: Hydrocolloid dressings (HCD) are helpful in chronic wound care, but research is limited in acute postoperative wounds. HCD can potentially be incorporated into a simplified wound care regimen after excisional surgeries. Objective: To examine whether a one-time HCD application after dermatologic surgery results in greater patient satisfaction and improved postoperative outcomes compared with conventional daily dressings (CDD). Methods: We examined patients who underwent Mohs or standard surgical excision with linear closure followed by HCD. The patients additionally had a history of excisional surgery with CDD in the past 5 years. A modified version of the validated Bluebelle Wound Healing Questionnaire was administered. Results: The survey response rate was 74.4% (64/86). Compared with CDD, HCD rated higher in comfort, convenience, scar appearance, and simplicity of wound care instructions (P < .0001). Nearly all patients (96.8%) preferred HCD over CDD. Limitations: Variability in time from prior dermatologic surgery may introduce recall bias. Prior surgeries involving CDD were sometimes performed by a different surgeon, which could introduce other confounding factors. Conclusions: A simplified wound care regimen involving HCD can potentially lead to increased comfort, convenience, simplicity, and a subjective improvement in scar appearance, though additional studies are needed.