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Background: Health-related quality of life is an important outcome in sexually transmitted infections, but data on genital herpes and genital warts in Sweden are limited. This study aimed to describe health-related quality of life in these patient groups at a Swedish STI clinic and to compare their scores with population norms and between the two diagnoses.

Methods: We conducted a clinic-based cross-sectional survey among adults with clinician-confirmed genital herpes or genital warts at an STI clinic in northern Sweden between November 2023 and September 2025. Health-related quality of life was measured using RAND-36. Global quality of life and sexual life were rated on visual analogue scales, and psychological symptoms were assessed with the DASS-21.

Results: In total, 91 patients were included, 45 with genital herpes and 46 with genital warts. Current visible lesions were more common in genital warts (98%) than in genital herpes (45%). No significant differences were observed between the groups in global quality of life, sexual life ratings and DASS-21 (all p > 0.12). In contrast, genital herpes patients scored lower than genital warts patients in RAND-36 domains: vitality (46.1 vs 56.7, p = 0.034); and social functioning (68 vs 79, p = 0.048). Compared with Swedish norms, genital herpes patients scored 15-27 points lower in mental and social domains (all p < 0.001), and 9 points lower in general health (p = 0.015). Genital warts patients scored 18 points lower in role emotional (p = 0.008).

Conclusions: Genital herpes and genital warts were both associated with impaired health and quality of life in this Swedish clinical sample. Genital herpes patients demonstrated greater mental and social impairment compared to those with genital warts and norms. These findings highlight the need for psychosocial assessment, clear information on transmission and recurrences, and targeted support for patients with pronounced psychological distress.

Objective: To investigate histopathological assessment practices following medical circumcision, analyse the prevalence of lichen sclerosus (LS) and assess the management of circumcised LS patients.

Material and methods: This retrospective study was conducted at Umeå University Hospital. A total of 416 patients aged ≥18 years who underwent medical circumcision between 2016 and 2023 were included. The variables investigated were the frequency of histopathological diagnosis of preputial tissue, pre- and post-surgery treatment, further management and the prevalence of LS.

Results: The mean (standard deviation [SD]) age of included patients was 47 (21) years. Before circumcision, 34% (141/416) of the study population had received treatment with potent or ultrapotent topical corticosteroids. A pre-operative diagnosis of LS was set in 4.8% (20/416) of the patients. Histopathological analysis of circumcised material was performed in 44% (183/416) of cases. Amongst these, LS was confirmed in 60% (110/183). Amongst the patients with histologically confirmed LS, 13% (14/110) received a recorded diagnosis of LS. A total of 15% (16/110) of the patients with LS were either referred to a dermatovenereologist and/or received treatment with an ultrapotent topical corticosteroid.

Conclusions: LS appears to be both underdiagnosed and not adequately treated in patients undergoing medical circumcision. Less than half of the circumcised specimens were analysed, which means a risk of missing LS and potential dysplastic changes. Most patients with LS did not receive adequate diagnosis and treatment after surgery. Failure to diagnose LS limits patient awareness, follow-up and appropriate care, factors that may contribute to disease progression and increased cancer risk.

The increasing incidence of cutaneous melanomas requires safe, efficient diagnostic methods to improve patient outcomes while optimizing healthcare resource utilization. Teledermoscopy was incorporated into clinical practice in 2014 in northern Sweden to improve diagnostic accuracy of cutaneous lesions and increase access to specialist dermatology care. This study aimed to evaluate whether teledermoscopy has led to earlier and more efficient diagnostics of cutaneous melanomas. Data on all excised pigmented cutaneous lesions from County Council of Västerbotten analysed at the Department of Clinical Pathology from 2010 to 2019 were collected. Before the introduction of teledermoscopy, the mean Breslow thickness was significantly higher (1.44 mm vs 1.08 mm, p=0.008), the proportion of Breslow ≤ 0.8 mm significantly lower (51.4% vs 70.6%, p< 0.001), and the mean Number Needed to Excise (23.32 vs 9.01, p< 0.001) significantly higher before the introduction of teledermoscopy. This indicates that teledermoscopy contributes to earlier and more efficient melanoma diagnosis.

Introduction: Teledermoscopy (TD), introduced in Västerbotten, northern Sweden in 2014, enables dermatological consultation in primary care via high-resolution images. As skin cancer incidence increases in Sweden, TD offers potential for diagnostic efficiency and resource optimisation. Despite increasing referrals, TD remains unevaluated. This study examines TD's impact on equitable access to dermatological assessment for skin tumours in this region.

Methods: This descriptive study analysed 67,137 TD referrals submitted between 2014 and 2024, excluding 2,384 due to incomplete data. Variables included age, diagnosis (benign vs malignant), and referral origin (public/private; urban/rural). A survey examined TD routines across primary care centres (PCCs), staff roles, training, and frequency of internal TD discussions.

Results: Over the 11-year period, mean age increased from 50 (2014) to 61 years (2024) (P < 0.001). The proportion of benign referrals decreased from 80% to 69% (P < 0.001). Private PCCs referred 78% benign lesions versus 75% from public PCCs (P < 0.001); urban PCCs referred 77% versus 73% PCCs in remote areas (P < 0.001). Assessment by a nurse was associated with higher benign referral rates (odds ratio (OR) 1.132, 95% confidence interval (CI) 1.052–1.219), whereas internal TD discussions (OR 0.714, 95% CI 0.669–0.763) and lack of dermoscopy training (OR 0.893, 95% CI 0.882–0.971) were associated with lower benign referral rates.

Discussion: TD has enhanced access to dermatological evaluation for suspected skin tumours in Västerbotten. The increasing age of referred patients and higher proportion of tumour diagnoses imply improved targeting of high-risk groups. Local routines influenced referral quality, underscoring the need for structured TD implementation.

Background: Sexually transmitted infections (STIs) may cause substantial individual suffering and a large economic burden for society. This study examined the seroprevalence of Chlamydia trachomatis, Mycoplasma genitalium, herpes simplex virus (HSV) types 1 and 2, and several human papillomaviruses (HPV) in the Swedish population over time.

Methods: The study population consisted of 30-year-old women attending maternity care, and 50 year-old men and women attending health check-ups, from 1975 to 2018. Antibody status was determined by multiplex serology and quantified using median reporter fluorescence intensity (MFI).

Results: A total of 891 samples were analysed (519 from 30-year-old women, 186 from 50 year-old women and 186 from 50 year-old men). Of these, 41.5% showed seropositivity for Chlamydia trachomatis, 16.7% for Mycoplasma genitalium, 70.5% for HSV-1, 14.9% for HSV-2, 13.2% for high-risk HPV, and 8.3% for low-risk HPV. Seropositivity for Mycoplasma genitalium, HSV-1 and especially Chlamydia trachomatis decreased over time.

Conclusions: There was a decrease over time in Chlamydia trachomatis seroprevalence, probably due to contact tracing, testing and early treatment; this might also have affected Mycoplasma genitalium seroprevalence. Despite the reduction, seroprevalences are still high, so continued and new efforts to reduce STI incidence are essential.

Studies have shown that psychological distress has a role in the symptomology of localized provoked vulvodynia. Therefore, psychosocial support has been presented as a valuable part of the treatment. However, little is known about which psychological variables that coincide with localized provoked vulvodynia. The purpose of this study was to identify qualities of psychological distress in patients with localized provoked vulvodynia. Patients with localized provoked vulvodynia were consecutively recruited to participate in this cross-sectional questionnaire-based study. Participants completed a self-report questionnaire measuring perfectionism, impostor phenomenon, self-compassion, anxiety and perceived stress. A sample of 30 patients were included. Questionnaire results suggestive of perfectionism was seen in 63%, impostor phenomenon in 80%, low self-compassion in 27%, anxiety in 43% and perceived stress in 23% of the participants. The level of self-compassion was higher in patients in a committed relationship. The investigated qualities appear to be more common in patients with localized provoked vulvodynia than in comparable groups. Impostor phenomenon and perfectionism were particularly common, with more than half of the study population scoring above the cutoff for clinical significance. This motivates research to investigate if interventions targeting impostor phenomenon and perfectionism, may aid in the treatment of localized provoked vulvodynia.

The aim of this study was to investigate whether Swedish swingers constitute a risk group for sexually transmitted infections (STIs). Two swinger clubs were invited to participate. At swinger meetings, members were offered an STI sampling kit and a questionnaire. Samples were analyzed for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis using a multiplex real-time polymerase chain reaction assay. In total, 235 swingers participated (118 women and 117 men). Urogenital C. trachomatis prevalence was 1.7%. Urogenital M. genitalium prevalence was 7.6% for women and 4.3% for men. No one tested positive for N. gonorrhoeae or T. vaginalis. For women, the mean number of unprotected temporary sex partners within the last 12 months was four men (range 0–35) and three women (range 0–50). Among men, the mean number of unprotected temporary sex partners within the last 12 months was five women (range 0–50) and 0 men (range 0–10). During vaginal sex, 46.6% women and 38.5% men always used protection with a temporary sex partner. Swedish swingers did not seem to have an increased prevalence of STIs. However, there was high-risk sexual behavior with unprotected sex and multiple sex partners, thereby making them a vulnerable group for acquiring STIs.

Objective: This study aimed to investigate the prevalence of sexually transmitted infections (STIs) and colonizing bacteria in relation to urogenital symptoms.

Materials and Methods: In this cross-sectional study, patients visiting the STI clinic at Umeå University Hospital were asked for symptoms and condom use. Samples from 759 patients (465 male and 294 female) were analyzed for 4 STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium) and 3 colonizing bacteria (Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum).

Results: Chlamydia trachomatis prevalence was 11% among women and 9.5% among men. Neisseria gonorrhoeae prevalence was 0.7% among women and 0.9% among men. Mycoplasma genitalium was found in 11% and 5.6% of women and men, respectively. Asymptomatic men and women had similar distribution patterns of microorganisms as those with urogenital symptoms, with the exceptions of Neisseria gonorrhoeae- and Mycoplasma genitalium-infected men who declared symptoms more frequently. Of 158 men with urogenital symptoms, 55% were test-negative. Of 129 women with urogenital symptoms, 12% were test-negative.

Conclusions: This study reveals a complex picture, where a large number of multi-positive tests made it complicated to correlate urogenital symptoms with microorganisms. A high number of test-negative but symptomatic patients indicate a need of searching for additional pathogens.

Objectives: The aim of the study was to investigate whether the use of dating apps is a risk factor for acquiring Chlamydia trachomatis (CT) infections.

Methods: Patients attending the drop-in facility at the STI clinic at Umea University Hospital between April 2016 and November 2017 were asked to fill in a survey about their sexual preferences and behaviors, including dating app use.

Results: Of 943 participants, 80 (8.5%) received a CT diagnosis (34 women and 46 men). Dating app users did not seem to have an increased risk of CT infection. Having 3 or more sex partners within the last year was a risk factor for CT only among those not using a dating app. Alcohol use before sex and unprotected sex with a new partner were risk factors for CT infection in the univariate but not in the multivariate analysis.

Conclusions: Dating app users did not seem to have an increased risk of acquiring CT and for dating app users the seemingly well-established risk factor of having many partners was not valid.