Genital Research Articles

The Treatment of Lichen Sclerosus with Topical Roflumilast 0.3% Case Study

Lichen Sclerosus is a chronic inflammatory skin disease predominantly affecting post-menopausal women. Currently, the first line treatment approach for lichen sclerosus is ultra potent topical corticosteroids for 12 weeks. A treatment challenge to this approach is the risk of steroid atrophy due to the use of potent topical steroids on the genital skin. We describe reduction of erythema and symptomatic improvement following treatment with topical roflumilast 0.3% once daily in a patient with lichen sclerosus who refused topical corticosteroids.

The genus Toyoides Matsumura (Hemiptera: Auchenorrhyncha: Delphacidae): new combination and lectotype designations

In this study, we revised the planthopper genus Toyoides Matsumura (Hemiptera: Auchenorrhyncha: Delphacidae) to include three species. The genus Epunka Matsumura be synonymized with Toyoides based on habitus and genital characteristics. The lectotype specimens have been designated for both T. albipennis and T. bilineata comb. n. Morphological information on T. bilineata comb. n. is presented, with photographs of the habitus and male genitalia provided. We have also provided the keys for the identification of related genera and species.

Female Genital Mutilation dan Pertanggungjawabannya Menurut Hak Asasi Manusia

Introduction: This study examines the practice of Female Genital Mutilation (FGM), involving cutting, scraping, or piercing female genital organs with the aim of partial or total removal, often based on cultural reasons. It is estimated that over 200 million women worldwide have undergone FGM.Purposes of the Research: The research evaluates whether FGM can be considered a violation of international Human Rights (HR) and whether countries and perpetrators of FGM can be held accountable under international law.Methods of the Research: Using a normative legal research method, focusing on international HR instruments such as the Convention on the Elimination of all forms of Discrimination Against Women (CEDAW).Results of the Research: The study finds that FGM is inconsistent with international HR values and can be categorized as a violation of HR against women. The study emphasizes the state's responsibility to protect women from this harmful practice and suggests the imposition of sanctions on perpetrators. However, it also highlights the complexity of addressing FGM due to variations in types and practices across different countries. Therefore, criminalization is not always seen as an ideal solution, stressing the need for a holistic approach that integrates health, cultural, and legal aspects. Efforts to prevent FGM are expected to align with international HR values without discriminating against specific cultures while preserving existing community traditions

A new alpine autumnal species of the genus Pediasia Hübner, 1825 (Lepidoptera: Crambidae) from Kyrgyzstan

A new species, Pediasia gorbunovi sp. nov., is described from Kyrgyzstan, Baidulu Mountains, at Dolon Pass (41°52’40”N, 75°42’11”E, 2790 m altitude). This species is distinguished from its closest relative, P. matricella (Treitschke, 1832), by its lighter wings with a less defined pattern and specific differences in male genitalia, particularly the structure of the aedeagus, saccus, and cucullus. P. gorbunovi is unique in being the only species of the P. matricella group found in high mountain environments.

On the taxonomy of the genus Lethe Hübner (Lepidoptera, Papilionoidea, Nymphalidae, Satyrinae) with description of a new species

New information on the genus Lethe is presented. A new species of the Lethe tristigmata-complex, L. sunglam sp. nov. is described from Mt. Fansipan, northern Vietnam. The individual variation of Lethe jianqingi Lang, 2016 is discussed and its female is reported for the first time and compared with the related taxa. Lethe lyncus de Nicéville, 1897 is found to be a good species different from the related congeners, and L. wui H. Huang, 1999 was synonymized with it (syn. nov.). Adults and male genitalia of the aforementioned taxa and related ones as well are illustrated.

Topical 5-aminolevulinic acid photodynamic therapy for genital vitiligo.

Vitiligo is an acquired chronic depigmentary skin disorder which results from the destruction of melanocytes. The clinical characteristic of vitiligo is the development of white macules due to the loss of functioning melanocytes in the skin or hair. Vitiligo in the genital area brings about a serious psychological impact on individuals. However, the choices of treatment for genital vitiligo are scarce. This study sheds light on the leverage of 5-ALA (5-Aminolevulinic Acid) Photodynamic Therapy (PDT) for the management of genital vitiligo. Nine patients with genital vitiligo who underwent 20% ALA-PDT treatment were reported. The results revealed that the treatment protocol simulated melanocyte regeneration in the patients effectively. ALA-PDT exerts significant anti-inflammatory effects by reducing pro-inflammatory cytokines and inducing regulatory T cells, which may help suppress the autoimmune response involved in vitiligo pathogenesis. Notably, five patients who were defined as responders showed moderate to excellent improvement in repigmentation and the treatment was well tolerated in all cases. Our findings suggest that ALA-PDT is a potential treatment option for genital vitiligo.

Urinary bladder: tumor precursors and non-invasive carcinoma

In recent years, our understanding of the genesis and development of urothelial carcinomas (UC) has expanded considerably thanks to advancing molecular classifications. These advances have led to significant changes in the 5thedition of the WHO classification of tumors of the urinary tract and male genitalia. The new findings allow both the introduction of modern diagnostic approaches and areturn to proven methods in the evaluation of precursor lesions and non-invasive carcinomas. This article is intended to provide asummarized overview of the various precursor lesions and pathways of urothelial carcinoma. The changes and clarifications in the 5thedition of the WHO classification reflect the progress made in the molecular and morphological characterization of urothelial carcinomas. These adjustments provide an improved basis for diagnosis and treatment and emphasize the importance of differentiated molecular profiles for the classification and treatment of UC. Despite all this, conventional histology remains the gold standard for the diagnosis and classification of non-invasive carcinomas and precursor lesions.

A new species of Quilessa Fennah from Saint Martin (Fulgoromorpha: Fulgoroidea: Kinnaridae: Prosotropini)

A new Kinnaridae species, Quilessa martinensis sp. nov. is described from Saint Martin in the Dutch Antilles. The new species differs from its congeners mainly in the shape of male genitalia, notably the shape of the aedeagus and anal tube. As in most other Quilessa species, the new species is an island-endemic. The high percentage of island-endemism suggests a higher species diversity in the Caribbean than is currently known.

A new species of Apatenia Pascoe (Coleoptera: Anthribidae) from central Madagascar, with a key to species, additions to the distribution of rare species of the genus, and general notes about threats to anthribid diversity

A new species Apatenia kuntei Trýzna & Rakotonirina sp. nov. (Anthribidae: Anthribinae: Platyrhinini) from the Ambohitantely Special Reserve in central Madagascar is described. Male and female genitalia are studied and illustrated. A key to all Malagasy Apatenia species is provided. Colour photographs, notes on the distribution and ecological notes on another four rare Malagasy Apatenia species are added. The decrease of the anthribid diversity due to fires and the spreading of expansive plants in the Ambohitantely Special Reserve is discussed.

Identification of novel variants and candidate genes in women with 46,XX complete gonadal dysgenesis.

46,XX complete gonadal dysgenesis (46,XX-CGD) is a rare disorder of sexual development (DSD) characterized by primary amenorrhea and a lack of spontaneous pubertal development in individuals with a 46,XX karyotype despite the presence of female internal and external genitalia due to failure of bilateral ovarian development. The condition is genetically heterogeneous, and in most cases, its etiology is unknown. Determining the genetic cause would provide insights into potential targets for genetic diagnosis and counseling. To clarify the molecular mechanisms of 46,XX complete gonadal dysgenesis in the population of China, whole-exome sequencing (WES) was performed on DNA samples from patients with 46,XX-CGD. In silico analysis was conducted to predict the pathogenicity of the variants. We recruited 20 patients with 46,XX-CGD and identified 8 variants in 6 genes, including three homozygous variants in MCM9, POF1B, and PSMC3IP; compound heterozygous variants in TWNK; and three heterozygous variants in TP63 and INSRR, from 7 patients. These variants included 3 recurrent variants and 5 novel variants. This study identified several novel variants, broadening the variant spectrum of 46,XX-CGD. 46,XX-CGD is a genetically heterogeneous condition, and WES is a powerful tool for determining its genetic etiology. The results of this study will aid researchers and clinicians in genetic counseling and suggest that WES is valuable for detecting 46,XX-CGD, which may lead to early interventions for patients.

Female genital cosmetic procedures from the perspective of health practitioners: a systematic review of knowledge, attitude and practice studies.

Currently, the popularity of female genital cosmetic procedures is on the rise worldwide. Despite the multiple roles of healthcare practitioners at different stages of women's decision-making for these procedures, limited studies have been conducted in this area. This systematic review aimed to summarize the available qualitative and quantitative data from observational studies that investigated healthcare practitioners' knowledge, attitudes and practices regarding female genital cosmetic procedures. The present systematic review was performed based on PRISMA guidelines. All published studies that examined the knowledge, attitudes and practices of healthcare practitioners regarding female genital cosmetic procedures were included. PubMed/Medline, Scopus, Web-of-science, ScienceDirect and Google Scholar were searched using related keywords until 30 November 2023. Quality assessment was performed using the Appraisal Tool for Cross-Sectional Studies and Checklist for Qualitative Research from the Joanna Briggs Institute. Eight studies comprising 2063 healthcare practitioners met the inclusion criteria and were analysed. Based on the results, some healthcare practitioners in the included studies acknowledged the naturalness of the variety of female genitalia, but others considered very small labia as attractive. There was little agreement on the positive effects of female genital cosmetic procedures on improving women's quality of life and sexual function in the included studies. Nearly all healthcare practitioners have seen women who had concerns about being natural of their genitalia. Meanwhile, approximately two-thirds of them had encountered women requesting female genital cosmetic procedures. Only three-quarters of healthcare practitioners felt confident in assessing the normality of genital appearance. The willingness to perform female genital cosmetic procedures was higher among male healthcare practitioners and plastic surgeons than among females and gynecologists. The results indicated that although a large number of healthcare practitioners had encountered women who were concerned about genitalia or requested genital cosmetic procedures, they did not have sufficient knowledge or favorable attitudes and practices in most related fields. Therefore, it is recommended to design educational interventions, formulate guidelines and make policies.

Syringocysadenoma Papilliferum Vulve – Tumor with Very Rare Localization on the Vulva

Syringocystadenoma papilliferum is a benign cutaneous adnexal tumor of eccrine and apocrine glands, with a warty appearance that is usually found on the scalp, neck and face, much less frequently appears in the chest or abdomen and extremely rarely on the female genital organs, i.e. the vulva. We present a case of Syringocystadenoma papilliferum on the vulva of a 64-year-old woman. This case illustrates the atypical location of this rare disease and adds to the differential diagnosis of lesions on the vulva.

The relationship between the vaginal and vulvar microbiomes and lichen sclerosus symptoms in post-menopausal women

Lichen sclerosus is a chronic inflammatory condition of unknown etiology that affects the genital and extragenital skin, which can lead to sexual dysfunction and has been associated with vulvar cancer. The vaginal microbiome has a critical role in gynecologic health, but little is known about the microbiome in lichen sclerosus. This study investigated the vaginal and vulvar microbiomes of 27 post-menopausal women with lichen sclerosus. The most abundant genera detected in the vaginal microbiome were Lactobacillus, Gardnerella, and Anaerococcus, while Lactobacillus, Anaerococcus, and Staphylococcus were the most abundant in the vulvar microbiome. The vaginal samples clustered into two main groups, Lactobacillus dominant (n = 6, > 50% microbiome Lactobacillus) and polymicrobial (n = 21) with no dominant genus. The vulvar samples were mainly polymicrobial (n = 25). Actinomyces, Anaerococcus, and Ezakiella in the vaginal microbiome and Actinomyces and Ezakiella in the vulvar microbiome were significantly associated with lichen sclerosus symptoms (adjusted p < 0.05). In this population of post-menopausal women with lichen sclerosus the majority have diverse, non-Lactobacillus dominant microbiomes, which is considered less optimal for gynecologic health based on studies of pre-menopausal women. Actinomyces, Ezakiella, and Anaerococcus were associated with lichen sclerosus symptoms. Understanding the role of these bacteria in lichen sclerosus pathogenesis will be an essential future investigation.

The Mosquitoes (Diptera: Culicidae) of Sonora: Distribution, Ecology, and the First Records of Aedes deserticola Zavortink and Toxorhynchites septentrionalis (Dyar and Knab) in México

The diversity and distribution of mosquitoes from Sonora, Mexico, was documented through entomologic surveys conducted in the four physiographic regions and sub-regions of Sonora: the Sonoran Plain, the Sierra Madre Occidental, the Northern Mountains and Plains, and the Pacific Coastal Plain. Immature stages were collected from aquatic habitats, while adult mosquitoes were collected using Shannon traps, resting in vegetation, and by human landing collections. Overall, 11,316 specimens, which comprised 493 larvae, 224 larval exuviae, 400 pupal exuviae, 33 pupae, 4552 females, 5607 males, and seven male genitalia, were identified. Two subfamilies: Anophelinae and Culicinae, seven tribes, 10 genera, 23 subgenera, and 56 species are reported below. Of these, one tribe, one genus, five subgenera, and 15 species were recorded for the first time in Sonora. Two species, Aedes deserticola Zavortink and Toxorhynchites septentrionalis (Dyar and Knab), are the first recordings of their kind nationwide. Toxorhynchites septentrionalis was also barcoded with the cytochrome oxidase subunit 1 (COI) gene. The presence of Psorophora columbiae (Dyar and Knab) is confirmed in Mexico. Taxonomic notes, new geographic distribution limits of mosquitoes in Sonora, and information regarding their importance as disease vectors are provided. By adding Ae. deserticola and Tx. septentrionalis and confirming Ps. columbiae in Mexico, there are currently 251 mosquito species in the Country.

Uveitis as a Predictor for Myocardial Infarction in Patients with Behçet's Disease, Multi Centric Cohort Study from Aseer Region, Saudi Arabia

Introduction: Behçet's disease (BD) is a chronic, multisystem inflammatory disorder characterized by a diverse array of clinical manifestations, including recurrent oral and genital ulcers, ocular inflammation, skin lesions, and joint problems. Its presentation varies, requiring tailored diagnosis and management. Methods: Retrospective cohort study, though review of medical charts and data for patients who meet the diagnostic criteria for BD actively receiving care in rheumatology clinics. The primary objective was to investigate the correlation between uveitis and Myocardial infarction in this population. Results: This study included a total of 111 patients. Approximately 33% of the patients exhibited positive CRP levels. Approximately 10% (11 patients) of the subjects were diagnosed with uveitis. Notably, the majority of individuals with uveitis were males. Three patients with uveitis had arthritis, none of whom presented with gastrointestinal tract (GIT) Complaints. Remarkably, none of the patients diagnosed with uveitis had a documented history of myocardial infarction (MI). Conclusion: In our cohort, those with a history of MI did not have a documented history of uveitis. Larger, prospective studies are needed to evaluate the associations between MI and uveitis in a BD population.

Pararhigognostis—a new genus for Plutella stichocentra Meyrick, 1932 (Lepidoptera, Plutellidae), with a redescription of its male and female genitalia

Pararhigognostis Baraniak &amp; Agassiz, gen. nov., is described and illustrated for the enigmatic Plutella stichocentra Meyrick, 1932. The morphology of male and female genitalia is described for the first time, and they serve to distinguish the new genus from all other genera of the family Plutellidae. The new genus is defined by the structure of the valva, long saccus, and shape of socii in the male genitalia, as well as by the shape of antrum and long, very thin apophyses posteriores in the female genitalia. The type species of Pararhigognostis, P. stichocentra, is redescribed. Line drawings of the male and female genitalia of the species are provided.

A new genus and a new species of microcotylids (Polyopisthocotyla, Platyhelminthes), gill parasite of the pink dentex Dentex gibbosus (Teleostei, Sparidae) off Tunisia and notes on Polyopisthocotyla and Monopisthocotyla from Dentex spp.

The study of the polyopisthocotylan parasites of marine fishes in the western Mediterranean is carried on using an integrative approach combining morphology and DNA barcodes. Ktarius patrickbrueli n. gen. n. sp (Polyopisthocotyla, Microcotylidae), from the gills of pink dentex Dentex gibbosus (Teleostei, Sparidae) from the western Mediterranean Sea off Tunisia, is described. Anatomical and morphological features of the new genus are described, and the molecular barcodes for nuclear and mitochondrial markers (28S rRNA and cox1) are generated. The new genus is closely related to Microcotyle by sharing a symmetrical haptor, inverted question mark-shaped ovary and unarmed vagina. However, Ktarius n. gen. can be distinguished from Microcotyle and other Microcotylinae taxa by an unarmed male copulatory organ, formed by a long muscular cirrus, a basal layer of concentric muscles, and an elongated thick-walled ejaculatory bulb. A partial 28S rDNA sequence of K. patrickbrueli n. gen. n. sp. was obtained and found to be distinct from all known microcotylid sequences, with a p-distance of 5–13%. A phylogenetic tree constructed from available microcotylid sequences revealed that K. patrickbrueli n. gen. n. sp. clustered in a strongly supported clade of Microcotylinae, containing species of Omanicotyle, Bivagina, and Microcotyle confirming its belonging to the Microcotylinae subfamily. The cox1 sequences of K. patrickbrueli n. gen. n. sp. were highly divergent from the closely related genus Pauciconfibula and confirmed its distinction. This new genus is the third polyopisthocotylan genus to be described from sparids of Dentex.

SRY+ Derivative X Chromosome in a Female With Apparently Typical Sexual Development.

When the SRY gene is present in a 46,XX fetus, some degree of testicular development is expected. Our laboratory performed prenatal genetic testing for a fetus that had screened positive for Y chromosome material by noninvasive prenatal screening (NIPS) but that had apparently typical female development by ultrasound imaging. The aim of this study was to determine the clinical relevance of the NIPS results. We analyzed fetal material obtained via amniocentesis procedure by G-banding, microarray, and fluorescence insitu hybridization (FISH). Optical genome mapping (OGM) was also performed. G-band analysis revealed a normal 46,XX karyotype. Microarray and FISH analyses together detected an SRY+ gain of 5.7 Mb from terminal Yp that was translocated to terminal Xq, with a loss of 1.6 Mb from terminal Xq. The final karyotype was 46,X,der(X)t(X;Y)(q28;p11.2). Prenatal ultrasound and postnatal physical examination revealed apparently typical female genitalia. The Xq deletion encompassed a gene, IKBKG, that is sensitive to loss of function, suggesting that preferential inactivation of the derivative X chromosome allowed for typical female development. OGM software did not directly identify this translocation. This case demonstrates how the SRY gene may be present in a 46,XX biological female without differences of sexual development.

First description of an intact copula in Coniopterygidae (Insecta: Neuropterida: Neuroptera) based on microCT imaging

The finding of a copulating pair of Coniopteryx (Holoconiopteryx) haematica (Mc Lachlan, 1868) offers the possibility to study the position of the elements of the genitalia of both sexes to each other for the first time in Coniopterygidae by using X-ray microcomputed tomography. The genital sclerites of the male resemble largely those of Coniopteryx (Coniopteryx) pygmaea (Enderlein, 1906) treated previously. Therefore, terminology and interpretation of the genital sclerites following the “gonocoxite concept” are adopted. The dominating eye-catching sclerite of the male is sternite 9 (the hypandrium externum of diverse taxa), the dominating sclerite of the female genitalia is the sclerotized spermatheca embedded in the “copulatory cup” of the hypandrium externum of the male. There is no indication that the genital sclerites of the male, the so called intromittent sclerites, are pushed into the female during copulation. They apparently function as a track for the distal part of the long slim ductus ejaculatorius.

Vulvar lichen sclerosus in girls and adult females: A single-center retrospective study of 744 patients in China.

Vulvar lichen sclerosus (VLS) is a chronic, inflammatory disease which is accompanied by itching and pain, affecting the patient's daily life and sexual activity. However, the disease characteristics of children and adults are not completely the same. Currently, there are few studies in China that compare the characteristics of VLS between girls and adult female patients. The aim of this study was to compare the epidemiology, clinical features, and combined autoimmune diseases of VLS patients between girls and adult females, and to help clinicians better understand VLS in different age groups. We enrolled 744 female patients for analysis, divided by age into a child group (<18 years) and an adult group (≥18 years). Among girl patients, 94.6% had preadolescent onset, while among adult female patients, only 4.6% had preadolescent onset, which was a statistically significant difference. The highest percentage of adult female patients had onset during their child-bearing period (75.4%), while 20% had postmenopausal onset, with a significant difference when the three onset states were compared. White patches were equally common in both girl and adult female patients' external genital area, while mossy lesions and labia minora atrophy were more common in adult female patients. Involvement of the clitoris, labia minora, and vaginal opening area were more common in adult patients. The perianal area was more commonly involved in girl patients. We found eight cases (1.2%) of secondary squamous cell carcinoma in adult female patients. We also found that 13 patients had concurrent lichen sclerosus lesions on the vulva and extragenital region, including two girls and 11 adult females. Extragenital lichen sclerosus (EGLS) occurred mostly in the torso. Clinicians should be aware of these differences so that early diagnosis and treatment of the disease can be achieved, to avoid irreversible anatomical alterations and the risk of cancer.