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Sexual Dysfunction

Sexual Dysfunction

Kevin T. McVary

Male sexual dysfunction affects 10 to 25% of middle-aged and elderly men. Female sexual dysfunction occurs with a similar frequency. Demographic changes, the popularity of newer treatments, and greater awareness of sexual dysfunction by patients and society have led to increased diagnosis and associated health care expenditures for the management of this common disorder. Because many patients are reluctant to initiate discussion of their sex lives, the physician should address this topic directly to elicit a history of sexual dysfunction.

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Seborrhoeic dermatitis

Seborrhoeic dermatitis

Seborrhoeic dermatitis is a skin eruption characterised by erythema and scaling. It is most common on the scalp and face but can also involve the upper trunk and flexures including axillae, groin, scrotum and anus. It is more common in patients with neurological disease such as Parkinson’s disease and in human immunodeficiency virus (HIV) infected patients. In HIV-infected patients it is more severe and may have unusual features.

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Sexually Transmitted Diseases: Overview and Clinical Approach

Sexually Transmitted Diseases: Overview and Clinical Approach

King K. Holmes

CLASSIFICATION AND EPIDEMIOLOGY

Certain sexually transmitted diseases (STDs), such as syphilis, gonorrhea, HIV infection, hepatitis B, and chancroid, are most concentrated within “core populations” having high rates of partner change, concurrent partners, or “dense” sexual networks—for example, prostitutes and their clients, some homosexual men, and persons involved in the use of illicit drugs, particularly crack cocaine and methamphetamine. Other STDs are distributed more evenly throughout society. For example, chlamydial infections, genital infections with human papillomavirus (HPV), and genital herpes can spread efficiently in relatively low-risk populations.

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Rosacea

Rosacea

Rosacea is a common chronic disorder of the face that tends to occur in middle age but may start as early as 20 to 30 years of age. It is more common in cold climates and is said to be most common amongst the Celtic race. The condition is frequently associated with flushing and characteristically fluctuates from day to day. Clinical signs include erythema, telangiectasia, papules, pustules and nodules. Unlike acne vulgaris, comedones are not seen. Long-term disease may contribute to the development of rhinophyma. The disease generally affects the mid-facial region, ie nose, glabella area, cheeks and chin, and may be associated with ocular complications.

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