Juliana Jorge Romano

Nodular vulvar lesions and its key differential diagnoses: a case report

The etiologies of vulvar nodules range from infectious to neoplastic. Owing to the wide spectrum of vulvar diseases, clinical differentiation of the lesions is crucial for adequate diagnosis and management. A 46-year-old patient presented with a nodular lesion in the vulvar region that had been growing slowly for 10 years. Gynecological examination revealed the presence of a solid nodular lesion measuring approximately 3 cm in the middle third of the right labia majora without phlogistic signs or secretion discharge. The lesion was excised and an anatomopathological study revealed a nodular hidradenoma. Nodular hidradenoma is a rare benign neoplasm of the apocrine glands that mainly affects women between 30 and 60 years of age. Although generally asymptomatic, some symptoms have been described, such as itching, pain, ulceration, or secretory discharge. The diagnosis was made by an anatomopathological study, and treatment consisted of total excision of the lesion without the need to enlarge the margin. During the investigation, malignant lesions such as liposarcoma of the vulvar region and non-melanoma skin cancers were excluded. Differential diagnosis is important because it requires a more invasive approach and surgical margins. This report aimed to expand the knowledge of the diagnosis of vulvar hidradenoma to exclude the possibility of malignant neoplasia while caring for vulvar nodules, thereby allowing proper management of the case.

Human papillomavirus vaccination: if the vaccine is important and available, why not use it?

SUMMARY BACKGROUND: Human papillomavirus (HPV) is the most common virus of the reproductive tract, is linked to cervical cancer, and can be prevented by vaccination, which is most effective if the vaccine is administered before sexual activity begins. METHODS: This descriptive, cross-sectional, and qualitative study was based on a survey containing 15 questions delivered to schools in three cities in the ABC region. Two schools from high-income neighborhoods and two from low-income neighborhoods were selected in each city based on real estate values. Data were expressed in absolute numbers and percentages and interpreted by descriptive analysis. The statistical tests of association were performed. RESULTS: Twelve schools were invited and nine agreed to participate. Of the 4,503 questionnaires delivered, 1,921 were completed by parents and guardians. The vaccination rate was 56.05% in private schools and 66.58% in public schools. Private vs. public school was not an independent factor for vaccination, but residing in a low-income neighborhood and city was a determinant factor. Approximately 40% of the parents/guardians reported not having their children vaccinated, primarily due to concerns about adverse effects. CONCLUSION: Despite being freely available and proven effective, the human papillomavirus vaccine remains underutilized. The reasons exposed in this paper may be useful in strategies to enhance vaccination coverage. Trial registration: This study was approved by the research ethics committee under the number 2.143.196.