Vulvovaginal Disease Update 2017 Co-Sponsored by:

Transcription

1 Vulvovaginal Disease Update 2017 Co-Sponsored by: The North American Chapter Of The International Society For The Study Of Vulvovaginal Disease & The Vulvovaginal Health Clinic Baylor College of Medicine Texas Children s Hospital Pavilion for Women March 17, 2017

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3 TABLE OF CONTENTS WELCOME P. 5 COURSE OBJECTIVES P. 6 COURSE FACULTY P. 7 CME INFORMATION P. 9 JOIN THE NA CHAPTER P. 10 HISTORY OF THE ISSVD P. 10 OTHER MEETINGS P. 11 ISSVD IPHONE APPS P. 12 PRE/POST TEST WORKSHEET P. 14 COURSE SCHEDULE P. 15 NOTES PAGES P. 17

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5 WELCOME Dear Practitioner: The Vulvovaginal Health Clinic at Baylor College of Medicine specializes in the care and treatment of women suffering from diseases of the vulva and vagina including vulvodynia, vulvar vestibulitis, vaginismus, chronic vaginitis, lichen inflammations, herpes, and HPV. Baylor holds a special place in history for the ISSVD, as Dr. Ray Kaufman, founding member of the ISSVD and Dr. Dale Brown, Past President and former secretary general of the ISSVD, held the longest running vulvovaginal course in the United States at Baylor before passing this institution on to the ISSVD in This course is now held in Chicago in the Fall on even years, carrying on the tradition. We hope to see you for the 24th Biennial Course in September of The ISSVD is pleased to be back in Houston and at Baylor for this special one day update. It is the goal of the ISSVD to promote international communication among gynecologists, pathologists, dermatologists, and related disciplines, and to establish international agreement on terminology and definitions of vulvovaginal diseases. We also aim to promote clinical investigation, basic research, and dissemination of knowledge in this field. We certainly hope that you feel like we have accomplished this goal by the end of this course. All of the course speakers are practitioners as well, and would welcome the opportunity to talk with you and answer any questions that should arise. We hope that this course will both bring awareness about the many vulvovaginal diseases, as well as assisting you in your everyday practice. The conference attendees represent a cross section of practitioners from various specialties representing more than 24 different states. Your active participation and feedback will assist us in providing meaningful courses in the future. We will be at your service over the duration of the course should you require assistance. Please do not hesitate to give her your comments and suggestions. We look forward to meeting and interacting with you, Sincerely, Course Director: Libby Edwards, MD Education Co-Directors Libby Edwards, MD of NA Chapter of ISSVD: Aruna Venkatesan, MD (not present) Page 5 of 18 Course Faculty: Libby Edwards, MD Hope Haefner, MD Kelly Hodges, MD Lynette Margesson, MD Anuja Vyas, MD

6 Upon completion of this course, participants will: COURSE OBJECTIVES Increase their current knowledge of vulvovaginal conditions Recognize the normal and abnormal anatomy of the vulva and vagina Gain awareness of the pathophysiology and treatment of benign vulvar conditions Understand the multiple contributions of the wet mount and be able to associate various vaginal conditions with their wet mount appearances Recognize and treat resistant vulvovaginitis Recognize the association of chronic vulvar dermatoses and vulvar intraepithelial neoplasia and squamous carcinoma Understand what is known about desquamative inflammatory vaginitis and atrophic vaginitis Review the common and uncommon infections of the vulva and vagina Gain insight into dermatoses of the vulva Have knowledge of treatment for pruritic conditions of the vulva Become more comfortable evaluating vulvar ulcerative conditions Understand the diagnosis and treatment of vulvar pain Gain understanding to how pelvic floor myalgia or vaginismus contributes to vulvar pain and sexual dysfunction Expand their knowledge of vulvar intraepithelial neoplasia, a pre malignant disease of the vulva Test their knowledge of various vulvovaginal diseases with lectures, cases and question and answer sessions Who should take this course? This course is ideal for clinicians who treat patients with persistent or recurrent vulvar symptoms not explained by simple yeast infections or bacterial vaginosis. This course is for those practitioners who treat itching, dyspareunia, and pain, as well as vaginal discharge and chronic rashes. The conditions include recurrent candidiasis, lichen simplex chronicus, lichen planus, lichen sclerosus, vulvodynia, ulcers, and desquamative inflammatory vaginitis. Course Educational Methods Lectures: Lecture sessions with time devoted to questions and answers are provided. Audience participation is encouraged. Course Syllabus: A USB flashdrive will be provided which includes PowerPoint presentations. A final program is available for download online at Evaluation: A link to the evaluation form is included on each session of the app. We ask that you please take the time to fill it out as you listen to each speaker, so that we may create future courses to meet your needs. Page 6 of 18

7 COURSE FACULTY Libby Edwards, M.D. is a medical dermatologist in private practice in Charlotte, North Carolina, and Chief of Dermatology at Carolinas Medical Center. She is board certified in Internal Medicine and Pediatrics as well as Dermatology, and about half of her practice consists of vulvology. She is a past president and past secretary general of the ISSVD, and the current secretary general of the North American Chapter of the ISSVD. She is committed to teaching in the office setting by mentoring, as well as by writing textbooks and reviews, and by speaking. - Past President, ISSVD - Past Secretary General, ISSVD - Southeast Vulvar Clinic, Charlotte, NC -Adjunct Associate Clinical Professor, University of North Carolina, Charlotte, NC Hope K. Haefner, M.D. is a professor in the Department of Obstetrics and Gynecology at the University of Michigan Hospitals. She opened the University of Michigan Center for Vulvar Diseases in She is a past president of the International Society for the Study of Vulvovaginal Disease. She is a past president of the American Society for Colposcopy and Cervical Pathology. Her particular research interests are in vulvodynia and non-neoplastic epithelial disorders of the vulva. Dr. Haefner has a special interest in education. She was Residency Director at the University of Michigan Department of Obstetrics and Gynecology from 1999 to Currently, she is involved internationally with vulvovaginal disease education. -Past Secretary General, ISSVD -Past President, American Society for Colposcopy and Cervical Pathology -Professor, University of Michigan, Department of Obstetrics & Gynecology, Ann Arbor, MI Kelly R. Hodges, M.D., assistant professor in the Department of Obstetrics and Gynecology, is boardcertified in Obstetrics and Gynecology. Dr. Hodges earned a masters of Science in Biotechnology from Northwestern University in Chicago, IL followed by her medical degree at the University of Illinois College of Medicine in Chicago. She completed her residency in Obstetrics and Gynecology at Medical College of Wisconsin in Milwaukee, WI. Dr. Hodges' clinical interests include alternative procedures to hysterectomy, minimally invasive surgery, pregnancy care, contraception and menstrual disorders. Page 7 of 18

8 Lynette Margesson. M.D. is very active in vulvar teaching, lecturing locally, nationally and internationally, is active in the International Society for the Study of Vulvovaginal Disease (ISSVD) and teaches regularly at the American Academy of Dermatology and the American College of Obstetrics and Gynecology meetings. She is the author of two textbooks on vulvar disease and has been a contributor to several others. She received her medical degree from University of Western Ontario in 1970 and finished her Fellowship in Dermatology in 1975 in Toronto. She was on the teaching staff at Queens University from 1976 until 1997 where she started the first combined vulvar teaching clinic in Canada with the Department of Obstetrics and Gynecology. She then moved with her dermatologist husband to New Hampshire where she is presently working in her vulvar teaching clinics. She is committed to promoting vulvar education and awareness of vulvar conditions. Anuja Vyas, M.D. is a physician and assistant professor of Obstetrics and Gynecology at Baylor College of Medicine. She is also Director of The Baylor College of Medicine's Pelvic Health and Wellness at Texas Children's Hospital Pavilion for Women. As an assistant professor at Baylor, Dr. Vyas is involved in teaching and mentoring medical students and residents. As a physician provider, Dr. Vyas specializes in general obstetrics and gynecology. She has a particular interest in caring for women during their pregnancies and, outside of pregnancy, in solving their vulvovaginal disorders including problems such as vulvodynia, dyspareunia, vaginismus, and the lichenoid disorders. Dr. Vyas evaluates and cares for women throughout all stages in their lives. She is currently accepting new patients and is looking forward to taking care of you. Page 8 of 18

9 CONTINUING MEDICAL EDUCATION INFORMATION ACCME Accreditation This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The American College of Obstetricians and Gynecologists and the International Society for the Study of Vulvovaginal Disease (ISSVD). The American College of Obstetricians and Gynecologists is accredited by the ACCME to provide continuing medical education for physicians. AMA PRA Category 1 Credit(s) The American College of Obstetricians and Gynecologists designates this live activity for a maximum of 8 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. College Cognate Credit(s) The American College of Obstetricians and Gynecologists designates this live activity for a maximum of 8 Category 1 College Cognate Credits. The College has a reciprocity agreement with the AMA that allows AMA PRA Category 1 Credits to be equivalent to College Cognate Credits. To complete this program successfully and receive credit and a certificate of attendance, participants must: Sign in at the ISSVD registration desk and attend the lectures Read the program objectives and program syllabus Read, complete and submit your course evaluation Disclosure of Faculty and Industry Relationships In accordance with College policy, all faculty and planning committee members have signed a conflict of interest statement in which they have disclosed any financial interests or other relationships with industry relative to topics they will discuss at this program. At the beginning of the program, faculty members are required to disclose any such information to participants. Such disclosure allows you to evaluate better the objectivity of the information presented in lectures. Please report on your evaluation form any undisclosed conflict of interest you perceive. Thank you! Your certificate of attendance can be printed off on the 2shoes app at Page 9 of 18

10 JOIN THE NORTH AMERICAN CHAPTER OF THE ISSVD The North American Chapter of the International Society for the Study of Vulvovaginal Disease held its first organizational meeting in Houston, Texas on March 15, 2009 in conjunction with the 19th Biennial Conference on Diseases of the Vulva and Vagina. The International Society for the Study of Vulvovaginal Disease approved the charter for the North American Chapter on September 17, 2009 at the XX World Congress in Edinburgh, Scotland. Subsequent meetings of the NA Chapter of the ISSVD have been held in conjunction with the Biennial Conference on Diseases of the Vulva and Vagina in Chicago in 2010 and The NA Chapter meetings will be will be held during the 'even' years. The next Scientific Meeting of the NA Chapter is being held on September 7-9, 2017, Chicago, IL. More information can be found at The Goals of the North American Chapter are: To promote communication and fellowship among gynecologists, pathologists, dermatologists, and other healthcare professionals. To promote clinical investigation, basic research, and dissemination of knowledge in this field. To promote an interest in vulvovaginal disease and foster the development of clinicians and researchers. Membership dues are $50 annually and give you access to the member directory and website, newsletters and a bi-monthly review of a difficult case. THE HISTORY OF ISSVD The International Society for the Study of Vulvovaginal Disease (ISSVD) was founded in 1970 at the Sixth World Congress of the International Federation of Gynecologist and Obstetrics (FIGO) in New York City. Over the following year, individuals throughout the world who shared a primary interest in vulvovaginal disease were identified and invited to join the new society as founding fellows. The inaugural session of the Society was chartered at the American College of Obstetricians and Gynecologists (ACOG) annual clinical meeting in San Francisco in Representatives of Dermatology and Pathology were also among the Founding Fellows. FELLOWSHIP WITHIN ISSVD At the present time, the ISSVD fellowship consists of approximately 400 gynecologists, dermatologists, pathologists, microbiologists, and others, all of whom have distinguished themselves in some area of the study of vulvovaginal disease, and considered capable of and willing to assist the Society in attaining its goals and purposes. Membership is also available to healthcare professionals with an interest in vulvovaginal disease. As a prerequisite for attainment of fellowship status, every candidate for fellowship must present a formal paper at a regular meeting (World Congress) of the Society. Page 10 of 18

11 The ISSVD has incorporated a membership status, member. A member does not have to present a formal paper in order to join the ISSVD. Members who wish to change to fellowship status may do so by presenting a paper at the World Congress. Members and Fellows must attend at least one of every three World Congresses to maintain membership in the Society and can present research studies or case reports at the World Congress. Costs include the meeting registration fees, travel expenses, a $150 initiation fee for new members/fellows, in addition to the annual dues of $150 for the calendar year joined. Membership and fellowship include a subscription to the Journal of Lower Genital Tract Disease. The Society s World Congresses are held every two years, with the location on different continents. REGISTERING NOW at Abstract submission Deadline: Extended to April 1, 2017 SAVE THE DATE: XXIV BIENNIAL CONFERENCE ON DISEASES OF THE VULVA & VAGINA EMBASSY SUITES CHICAGO, IL SEPTEMBER 7-9, 2018! 11 Page 11 of 18

12 The ISSVD has developed two apps for the App store. The Vulvovaginal Candidiasis (Candida, Yeast): Tips for Diagnosis and Treatment *app is designed for health care professionals and other individuals to understand the different types of vulvovaginal yeast infections and treatment options. This interactive app is intended to be used in conjunction with patient care to assist with ;inding the best treatment plan for the individual patient, whether it is a simple Candida infection or a recurrent infection. With the Vulvovaginal Candidiasis (Candida, Yeast) app you can: - View clinical images such as wet mount examples and vulvar whitening or erythema from Candida infections - Obtain information on a variety of oral and topical medications (including compounded treatment options) with over the counter and prescription alternatives for multiple Candida types - Provide patients with general information on vulvovaginal Candida infections, which is easily downloaded for printing *SOON TO BE AVAILABLE IN SPANISH The Vulvar and Vaginal Ulcers: Tips for Diagnosis and Treatment **app is designed for health care professionals and other individuals to understand the different types of vulvovaginal ulcers and treatment options. This interactive app is intended to be used in conjunction with patient care to assist with finding the best treatment plan with individual patient and their acute or recurrent/ chronic genital ulcers. Using Vulvar and Vaginal Ulcers app you can: - View clinical images of common and unusual vulvar and vaginal ulcers - Understand the difference of an ulcer from an erosion - Easily access a user friendly algorithm for vulvovaginal ulcers - Become familiar with the current testing for a variety of ulcerative conditions - Obtain information on a variety of medications and other treatments utilized to manage the ulcers ** COMING SOON Page 12 of 18

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14 PRE-TEST POST-TEST Page 14 of 18

15 Vulvovaginal Disease Update 2017 Friday, March 17, 2017 Time Topic Speaker 8:00-8:15 Scientific Objectives Hope Haefner, MD 8:15-8:45 Basic Principles of Diagnosis and Therapy of Chronic Vulvovaginal Symptoms, Wet Mount Libby Edwards, MD 8:45-9:15 Recalcitrant and Recurrent Yeast and BV Kelly Hodges, MD 9:15-9:35 Noninfectious Inflammatory Vaginitis Hope Haefner, MD 9:35-10:05 Lichen Sclerosus - Beyond Clobetasol Lynne Margesson, MD 10:05-10:25 Question/Answer Faculty 10:25-10:35 Break 10:35-11:10 Chronic Vulvar Itching Common Causes and Therapy Libby Edwards, MD 11:10-11:40 Lichen Planus A Common Management Challenge Lynne Margesson, MD 11:40-12:10 Pediatric Vulvar Diseases Libby Edwards, MD 12:10-12:30 Vulvar Ulcers Lynne Margesson, MD 12:30-1:30 Lunch 1:30-1:50 Vulvodynia Causes and Diagnosis Hope Haefner, MD 1:50-2:15 Management of the Patient with Vulvodynia Libby Edwards, MD 2:15-2:40 Sexual Dysfunction in Women With Vulvar Diseases Anuja Vyas, MD 2:40-3:05 VIN or HSIL? Hope Haefner, MD 3:05-3:20 Question/Answer 3:20-3:30 Break 3:30-3:55 Hidradenitis Suppurativa Lynne Margesson, MD 3:55-4:45 Your Diagnosis Is? Edwards, Haefner, Margesson 4:45-5:00 Post Test/Wrap-up Libby Edwards, MD Page 15 of 18

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17 NOTES Page 17 of 18

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