Sexually transmitted infections

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A 60-year-old woman reportsthat she has felt intermittent“fullness” in her face for the past day.This sensation is present when sheis supine on the examination table.She denies shortness of breath, dysphagia,and chest discomfort. Thepatient has a 25 pack-year history ofcigarette smoking.

SEATTLE -- The human papillomavirus has a long racial memory. So concluded researchers here, who found that variants of two carcinogenic HPV types tend to linger longer in women whose ancestors came from the same area where the variants first arose.

A 24-year-old woman's first pregnancy was uneventful until the sixth month when mild malaise and a highly pruritic abdominal rash occurred. A biopsy and direct immunofluorescence confirmed the suspected diagnosis of herpes gestationis.

ROCHESTER, Minn. ?Treating obese patients with chronic hepatitis C infection with a diet-and-exercise regimen could improve both their overall health and their response to antiviral therapies, researchers suggest.

You routinely order laboratory screeningpanels, including serum liver enzymemeasurements, for nearly everypatient who has a complete physicalexamination or who is seen for any ofa host of other complaints. If you findabnormal liver enzyme levels, your familiaritywith the common causes andthe settings in which they occur mayenable you to avoid costly diagnosticstudies or biopsy.

For 3 days, a 10-year-old girl had redness and vesicles on her right volar wrist. She had not had any pain, fever, or other systemic symptoms.

The widespread eruption of asymptomatic macules and flat, palpable, flesh-colored lesions prompted a 23-year-old woman to consult her physician. The lesions-some of which had dark centers-were concentrated on the patient's face, neck, and upper back; the palms, soles, anal mucosa, and genital areas were clear. The patient denied systemic symptoms. She was seronegative for HIV.

Acute herpes zoster ophthalmicus of the right eye was diagnosed in a 70-year-old woman by her primary care physician, who prescribed oral acyclovir. After 1 week of therapy, the patient's eye became red and painful and she experienced photophobia and epiphora. She was referred for consultation.

A 29-year-old man presented with a complaint of venereal warts and a long history of mild psoriasis, which he had treated with fluocinolone. He returned 3 months later complaining of chest congestion of 10 days' duration; it had been treated with ciprofloxacin at an urgent care facility.