Psoriasis is one of the most prevalent immune mediated skin diseases worldwide. Despite the large prevalence in both men and women, the pathogenesis of this disease has not yet been fully clarified. Nowadays, it is believed that psoriasis is most likely a T helper Th1/Th17 induced inflammatory disease. Stressful life situations are known to cause flare-ups and psoriasis activity may be linked to stress from major life events. We know that stress greatly affects both the hormone and immune systems and that there are many different hormonal phases throughout a woman's lifetime. The severity of psoriasis may fluctuate or be influenced by each phase and this relationship can be seen as disease frequency seems to peak during puberty, postpartum, and menopause when hormone levels fall, while symptoms improve during pregnancy, a state when hormone levels are increased.
Introduction
The prevalence of sexual health difficulties among women in Croatia is presently unknown. Although women under 40 years of age may be exposed to the most intense demands of the dual role (career and motherhood), they are often assumed to be at lower risk for sexual difficulties.
Aim
To assess the prevalence of sexual difficulties in a population-based study of women aged 18–35 and to explore the possible impact of the dual role on female sexual health.
Methods
The study was carried out in April 2010 on a multistage probability sample of 1,000 women aged 18–35 years. The response rate was 37.3% (1,680 women refused to participate). Multivariate logistic regression was used to analyze the correlates of sexual difficulties, including the dual role.
Main Outcome Measures
The prevalence of the four most common female sexual health difficulties (lack of desire, lubrication difficulties, inability to reach orgasm, and pain during intercourse) were measured using the one-item indicators from the Global Study of Sexual Attitudes and Behaviors.
Results
Among coitally experienced women (N=870), 27.6% reported having a lack of desire, 23.6% pain during sexual intercourse, 23.1% inability to reach orgasm, and 18.5% difficulties with genital lubrication. All four difficulties were negatively associated with sexual satisfaction, but only the lack of sexual interest and inability to reach orgasm seemed to substantially decrease sexual well-being. In multivariate analyses, age, education, being in a steady relationship or married, and partner communication about sexuality were significant correlates of reported sexual difficulties. The dual role was not a significant predictor of sexual health difficulties.
Conclusions
A substantial proportion of participants reported one or more sexual health difficulties that lasted for at least 2 months. Women in the dual role were not at an increased risk of experiencing difficulties in sexual functioning.
Leukocytoclastic vasculitis is a disease mostly limited to the skin. Extracutaneous manifestations that include visceral involvement are normally self-limiting and not life-threatening. We describe a 44-year-old man with palpable purpura, polyarthritis and microhematuria who developed severe vasculitis of the small and large bowel. Initial laboratory tests confirmed leukocytosis, slightly elevated C-reactive protein and mildly increased erythrocyte sedimentation rate. Skin biopsy revealed histological features typical of leukocytoclastic vasculitis. The search for trigger factors revealed urogenital infection with Ureaplasma urealyticum. Severe abdominal pain followed cutaneous symptoms eight days after admission. Abdominal x-ray showed several air-fluid levels in the lower right abdomen and an abdominal CT scan revealed thickening of the intestinal wall in several segments of jejunum, ileum and colon. C-reactive protein rose from 32 mg/l to 107 mg/l. Methylprednisolone pulse therapy rapidly improved gastrointestinal, cutaneous and articular symptoms. The aim of this report is to show the unpredictability of vasculitic disease and the difficulties in its classification. The report emphasizes the importance of adapting diagnosis and treatment according to disease severity rather than to the type of vasculitis. The specific etiological trigger remains unknown in this case, although a causal relationship with U. urealyticum infection is speculated.
Unusual scrotal and penile ulcerations together with palmarplantar erythrodysesthesia syndrome in a patient with metastatic colon carcinoma treated with capecitabine. Journal of the European Academy of Dermatology and Venereology, 31 (6). pp. e304-6.
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