Orphenadrine (sold under many brand names) is an anticholinergic drug of the ethanolamine antihistamine class; it is closely related to diphenhydramine. It is a muscle relaxant that is used to treat muscle pain and to help with motor control in Parkinsons disease, but has largely been superseded by newer drugs. This substance is considered a dirty drug due to its multiple mechanism of action in different pathways. It was discovered and developed in the 1940s. Medical use
Orphenadrine is a skeletal muscle relaxant. It is used to relieve pain caused by muscle injuries such as strains and sprains, in combination with rest and physical therapy. A 2004 review found fair evidence that orphenadrine is effective for acute back or neck pain, but found insufficient evidence to establish the relative efficacy of the drug in relation to other drugs in the study.Orphenadrine and other muscle relaxants are sometimes used to treat pain arising from rheumatoid arthritis but there is no evidence they are effective for that purpose.A 2003 Cochrane Review of the use of anticholinergic drugs to improve motor function in Parkinsons disease found that as a class, the drugs are useful for that purpose; it identified one single-site randomised, cross-over study of orphenadrine vs placebo. Although orphenadrine and other anticholinergics have largely been superseded by other drugs; they have a use in alleviating motor function symptoms, and appear to help about 20% of people with Parkinsons. Side effects
Orphenadrine has the side effects of the other common antihistamines in large part.
Differentiated vulvar intraepithelial neoplasia also known as VIN Simplex: is associated with vulvar dermatoses such as lichen sclerosus. It is associated with atypia of the squamous epithelium. Risk factors
The exact cause of VIN is unknown. Studies are being done to determine the cause of VIN. The following factors have been associated with VIN:

HPV (Human Papilloma Virus)
HSV-2 (Herpes simplex Virus - Type 2)
Smoking
Immunosuppression
Chronic vulvar irritation
Conditions such as Lichen Sclerosus

Diagnosis
The person may have no symptoms, or local symptomatology including itching, burning, and pain. The diagnosis is always based on a careful inspection and a targeted biopsy of a visible vulvar lesion. The type and distribution of lesions varies among the two different types of VIN. In the Usual type VIN, seen more frequently in young patients, lesions tend to be multifocal over an otherwise normal vulvar skin. In the differentiated type VIN, usually seen in postmenopausal women, lesions tend to be isolated and are located over a skin with a vulvar dermatosis such as Lichen slerosus. Prevention
Vaccinating girls with HPV vaccine before their initial sexual contact has been claimed to reduce incidence of VIN. References
External links

VIN at DermNet.NZ