Dermatological Examination Research Articles

When Epilepsy Takes Center Stage in Tuberous Sclerosis Complex: A Case Report from the Dermatology Hospital of Bamako

Tuberous Sclerosis Complex (TSC) is a multi-organ genetic disorder characterized by numerous hamartomas found in several organs, including the brain, heart, skin, eyes, kidneys, lungs, and liver. The responsible genes are TSC1 and TSC2, encoding hamartin and tuberin, respectively. The hamartin-tuberin complex inhibits the mammalian target of rapamycin pathway, which controls cell growth and proliferation. Variations in the distribution, number, size, and location of lesions lead to variations in the clinical syndrome, even among family members. Most features of Tuberous Sclerosis Complex become evident only in childhood, after the age of 3, limiting their usefulness for early diagnosis. Identifying patients at risk of severe manifestations is crucial. We report a case of Tuberous Sclerosis Complex inaugurated by epilepsy. It is a 10-year-old girl, a student, who came for consultation for a black spot on her left cheek evolving continuously for seven years. Two months later, this spot, asymptomatic solid lesions appeared on her face, gradually increasing in size and number. In her medical history, she has had convulsive seizures since the age of three, occurring at least five times a year, confirmed by an electroencephalogram. There is an oblong-shaped skin plaque measuring approximately 7x3 cm, erythematous, on the left cheek. Additionally, there are multiple normochromic angiofibromas affecting the nasal pyramid, nasolabial folds, and cheeks. The rest of the dermatological examination is unremarkable. The diagnosis of Tuberous Sclerosis Complex was made. In the presence or absence of cutaneous lesions, when faced with epilepsy in young children, we must always consider Tuberous Sclerosis Complex before ruling out other causes.

Possible Role of Platelet-Rich Plasma in the Treatment of Patients with Postherpetic Neuralgia: A Prospective, Single-Arm, Open-Label Clinical Study

Abstract Background: Currently, no treatment can fully and finally treat postherpetic neuralgia (PHN). Objectives: This study aimed to evaluate the possible efficacy of autologous intralesional platelet-rich plasma (PRP) injection in treating patients with PHN. Materials and Methods: A prospective, single-arm, open-label clinical study was conducted on 45 patients with PHN attending the Dermatology Outpatient Clinics of Sohag University Hospital, Egypt, between November 2019 and November 2021. Patients were subjected to full clinical general and dermatologic examinations. Patient’s assessment included; severity of pain through visual analogue scale (VAS), numerical rating scale (NRS), and verbal rating scale (VRS), in addition to Medical Outcomes Study 36 Item Short-Form (SF-36). Patients were treated by autologous PRP injection every 2 weeks for 2 months (4 sessions). Patients were evaluated before every session and 3- months after the last session. Results: There was a significantly decreased VAS, NRS, VRS, and SF-36 questionnaire values in the last session and three months after the last session. There was a highly significant moderate correlation between both scales (VAS and VRS) and patient’s age in years and who have aggravating factors. Likewise, there was a significant moderate positive correlation between scales (VAS and VRS) and the disease duration, medical co-morbidities, and associated myalgia. Limitations: These findings require further confirmations on more inclusive large-sized multicenter, randomized, placebo-controlled, clinical trials with longer follow-up. Conclusion: This clinical pilot study concluded that autologous intralesional PRP injection was an effective therapeutic option for patients with PHN.

Dermatological Knowledge and Image Analysis Performance of Large Language Models Based on Specialty Certificate Examination in Dermatology

Large language models (LLMs) are trained using large datasets and may be applied to language-based tasks. Studies have demonstrated their ability to perform and pass postgraduate medical examinations, and with the increasingly sophisticated deep learning algorithms and incorporation of image-analysis capabilities, they may also be applied to the Specialty Certificate Examination (SCE) in Dermatology. The Dermatology SCE sample questions were used to assess the performance of five freely available and high-performance LLMs. The LLMs’ performances were recorded by comparing their output on multiple-choice questions against the sample answers. One hundred questions, four of which included photographs, were entered into the LLMs. The responses were recorded and analysed, with the pass mark set at 77%. The accuracies for Claude-3.5 Sonnet, Copilot, Gemini, ChatGPT-4o, and Perplexity were 87, 88, 75, 90, and 87, respectively (p = 0.023). The LLMs were generally capable of interpreting and providing reasoned responses to clinical scenarios and clinical data. This continues to demonstrate the potential of LLMs in both medical education and clinical settings.

Hair fragility (trichorrhexis nodosa) in alopecic Pomeranian dogs.

While alopecia associated with hair cycle arrest (HCA, Alopecia X) is well-recognised in Pomeranian dogs, the authors are unaware of reports of concurrent hair fragility. Following the observation of frequent hair shaft abnormalities in alopecic Pomeranians, we hypothesised that hair fragility events would be more frequent in dogs with a phenotype of HCA when compared to dogs with normal coats. Eight alopecic Pomeranian dogs or crosses with a phenotype of HCA and 36 unaffected Pomeranians with owner-reported normal hair coats. All affected dogs underwent dermatological examination and clinicopathological evaluations. Hair samples, plucked from affected areas or obtained by brushing from unaffected dogs, were examined microscopically for structural abnormalities. Hair fragility events were characterised as trichorrhexis nodosa (TN) or longitudinal splits and were expressed per 10 mg of hair. A reference interval was calculated from the number of hair fragility events in the samples from unaffected dogs. The upper reference limit (with 90% confidence) from samples of 35 unaffected Pomeranians (one outlier excluded) was 9.75 hair fragility events per 10 mg of hair. The median (range) of fragility events in eight dogs with a phenotype of HCA was 66.0 (30.2-166.7) per 10 mg of hair. Clinicians should routinely perform trichography in Pomeranians with HCA because abundant hair abnormalities, particularly TN, may contribute to poor hair coat quality. Further studies are required to establish the pathophysiology of and treatments for these fragility events and to determine their predictive value for HCA.

Assessment of serum levels of ischemia modified albumin and interleukin-17 in children with atopic dermatitis.

Atopic dermatitis (AD) is the most prevalent chronic inflammatory skin disease in childhood. Interleukin 17 (IL17) is one of the pro-inflammatory cytokines that has an important role in the pathogenesis of many skin diseases including AD. Ischemia modified albumin (IMA) is an indicator of oxidative stress, inflammation and ischemia. The aim of the study was to assess the IL-17 and IMA serum levels in the children patients with AD in comparison to a control group. Additionally, the study seeks to examine the correlation between these biomarkers and their association with disease severity, disease stages, and other clinical characteristics. The case-control study enrolled two groups: (patient group: 50 children with AD) and (control group: 50 healthy age and sex-matched children). Full history was taken from all cases along with full dermatologic examination. The assessment of AD severity was conducted by using Eczema Area and Severity Index (EASI). Evaluation of IL-17 and IMA was performed by using ELISA technique. There was a statistically significant elevation in the mean levels of IL-17 and IMA in patients with AD compared to the control group. A strong positive correlation was observed between IL-17 and IMA levels. Additionally, both IL-17 and IMA levels exhibited a statistically significant negative correlation with the duration of the disease and the age of the patients. The elevated serum levels of IL17 and IMA and their positive correlation confirm that AD is a systemic inflammatory disease influenced and associated with increased oxidative stress.

Survey on Dermatological Disorders of Dogs during 2020-2022 in Rabat, Morocco

Dermatology is an important specialty in veterinary medicine, focusing on the skin and its appendages. Therefore, the present study highlighted the percentage of skin disorders, as well as their associated risk factors, from cases received at the Parasitology-Dermatology clinic of the Hassan II Institute of Agronomy and Veterinary Medicine (IAV Hassan II), Rabat, Morocco for two years. A total of 1561 dogs (1450 dogs were in 28 different pure breeds and 111 dogs were mongrels, 805 males, and 756 females, with an average age of 6.5 years old) were presented at the University Veterinary Teaching Hospital (UVTH) of the IAV Hassan II from the end of October 2020 to the end of May 2022 (including vaccinations) and 125 dogs were assessed and 161 skin diseases were found (a few dogs had more than one skin disease). Dermatological examinations represented an average of 8.00% (125/1561) of all canine cases received at the University Veterinary Teaching Hospital. The most common clinical signs were pruritus, alopecia, erythema, onychogryphosis, and visible ectoparasites. Parasitic dermatoses were the most frequent, representing 44.10% of all dermatological cases, followed by allergic dermatoses (25.47%) and fungal skin infections (19.25%). Bacterial skin infections and dermatological manifestations of endocrine disorders were infrequent, representing 8.70% and 2.48%, respectively of all observed cases. Risk factors contributing to the occurrence of canine skin disorders included age and lifestyle for sarcoptic mange. An apparent predilection for the living environment was observed in the case of canine leishmaniosis, and an apparent predilection for sex regarding otodectic mange was also demonstrated. Similar results were found for the living environment and lifestyle concerning canine atopic dermatitis. Data reported herein fill gaps in knowledge of skin disorders and their associated risk factors in dogs in Morocco, demonstrating the dominance of skin diseases of zoonotic interest, including flea bite allergy dermatitis (FBAD), dermatophytosis, and canine leishmaniosis.

The Importance of Dermatological Detection of Xanthomas and Xanthelsemas in Pediatric Patients: A Summary of Case Reports

Diseases such as sitosterolemias, familial hyperlipidemias, and familial hypercholesterolemias are characterized by unique dermatological manifestations, including eruptive xanthomas and xanthelasmas. Although these conditions are relatively rare in dermatology, they hold significant implications for cardiovascular health, potentially leading to fatal outcomes such as atherosclerotic disease, acute coronary syndrome or hypertensive encephalopathy if untreated. These diseases are particularly notable in pediatric populations and effective preventative treatment can be administered if these lipid-related disorders are detected early. This case series summary highlights various case reports to underscore the critical qualitative dermatological findings associated with these lipid disorders in children. By identifying these signs early through comprehensive dermatological examinations, it is possible to initiate preventative treatments that mitigate the risk of severe cardiovascular disease and other systemic diseases later in adulthood. The aim of this case series is to highlight these dermatological indicators clearly, providing dermatologists with a reliable reference for early diagnosis and intervention, thus highlighting the importance of dermatological assessment in preventing serious health outcomes associated with pediatric lipid disorders.

Abstract C012: Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students

Abstract Introduction: Medical student curriculum is lacking in standardized training of skills for conducting the skin cancer screening examination. Dermatology is not a standard clinical rotation during medical school, and many medical students do not have much exposure to the specialty of dermatology for hands-on training in skin examinations by dermatologists. We sought to create an event in conjunction with the Sun Bus that included education about dermatology and skin examination for medical students. Objectives We sought to assess how the effects on knowledge of dermatology and skin cancer prevention and screening among participating medical students changed from participating in the educational event. Methods: The Health Education and Awareness Team of Texas Tech University Health Sciences Center El Paso collaborated with The Sun Bus to organize a training event for medical students. During this event, students had the opportunity to listen to a panel about dermatology as well as the basics of skin cancer screening from working dermatologists. Students also received a brief training on skin cancer screening provided by The Sun Bus and conducted screenings alongside dermatologists during a free skin cancer screening event. Students completed voluntary pre-event and post-event surveys. Results The vast majority of students did not feel confident in their ability to screen for skin cancer prior to attending the event. This research showed improved student confidence in providing skin cancer screenings and identifying suspicious skin lesions from the intervention. Conclusion: Medical students lack standardized training in dermatology and in the dermatologic skin cancer screening examination. This student educational event represents a meaningful intervention that improved medical students’ confidence in providing skin cancer screenings and identifying suspicious skin lesions. Bibliography The Sun Bus. https://www.thesunbus.org/about-us Accessed 11 Dec 2023. Compres E, Holzem K, Ibler E, Bierman JA, Rademaker AW, Kundu RV. A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence. MedEdPORTAL. 2020;16:11049. Published 2020 Dec 29. doi:10.15766/mep_2374-8265.11049 Moore MM, Geller AC, Zhang Z, et al. Skin cancer examination teaching in US medical education. Arch Dermatol. 2006;142(4):439-444. doi:10.1001/archderm.142.4.439 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Citation Format: Elian A. Martin Lopez, Hannah Riva, Shravya Kichena Kichena, Daniel Lovasz, Brian Kan, Tannis Hogg, Jessica Chacon. Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C012

Feasibility study on virtual reality-based training for skin cancer screening: Bridging the gap in dermatological education

AbstractDespite growing interest in the inclusion of virtual reality (VR) in medical education, its full potential for immersive and interactive training remains underutilized, particularly in dermatology. As part of a multidisciplinary project, we tested the feasibility of integrating a VR training scenario for a complete skin cancer screening into the curriculum with 58 medical students. The evaluation focused on simulation usability, cognitive task load, immersion, change in perceived competence, suitability, and cybersickness using established and adapted questionnaires. Participants reported rather high levels of system usability and immersion and medium cognitive task load. Self-assessed competence in performing a skin cancer screening increased significantly after the training simulation.Prior skin cancer screening experience correlated positively with self-assessed competence and theoretical knowledge, which themselves were neither related to gender nor age. Age correlated negatively with perceived usability and immersion, enjoyment of learning during the simulation and assessed appropriateness of the simulation to learn a dermatological full-body examination while being positively correlated with perceived cybersickness. Gender was significantly associated with the need for technical help during the simulation and openness to new technologies.As a blueprint of a feasibility evaluation, this study can contribute to further refinement of the presented and relatable VR applications in medical curricula.

Correlation between meibomian gland dysfunction and sebaceous adenitis in dogs.

Sebaceous adenitis (SA) is an immune-mediated disease targeting the sebaceous glands. Meibomian gland dysfunction is a disease affecting meibomian glands with inflammatory features. Sebaceous and meibomian glands share anatomical, physiological and embryological similarities. The involvement of meibomian glands in dogs with SA is currently unknown. To evaluate meibomian glands in dogs affected by SA and compare them with healthy dogs. Eighteen dogs were enrolled. Nine dogs with SA were retrospectively identified from clinical records and represented the case group. Nine healthy, breed- and age-matched dogs were prospectively enrolled in the control group. Both groups underwent dermatological examination, Schirmer tear test-1 (STT-1), tear meniscus height (TMH), slit-lamp biomicroscopy, interferometry (INT) and noncontact infrared meibography (NIM). One third of SA dogs presented subepithelial crystalline opacities. No significant difference between groups was observed in TMH (p = 0.944) and STT-1 values (p = 0.066). INT (p = 0.016) and NIM grades (p = 0.010) were significantly higher and lower in the SA group compared to the control group, respectively. INT values decreased with age (η = 0.930), while NIM scores (η = 0.935) increased. Clinical Relevance: Subepithelial crystalline opacities in SA dogs might reflect a reduced tear film quality. In the absence of standardised methods, INT and NIM proved to be noninvasive and useful methods to examine meibomian glands. Dogs with SA showed a thinner lacrimal lipid layer and more severe meibomian gland abnormalities than control dogs, which seemed to progress with age.

Chondroid Syringoma of scalp- A Case Misdiagnosed Clinicoradiologically as Dermoid Cyst

Chondroid syringoma (CS) is a rare tumor of the apocrine or eccrine glands. CS of the scalp is rare, and its clinical manifestations are similar to those of dermoid cyst, which is a common misdiagnosis for this disease. A 26-year-old woman presented with a 2-month history of an asymptomatic subcutaneous mass on the scalp. The lesions increased progressively over time. Dermatological examination showed that there was a subcutaneous mass, ranging from 2x2 cm in diameter, with a clear boundary. The surface of the skin was smooth without ulceration or scaling. Histopathologic examination was consistent with the diagnosis of CS. CS is a rare tumor of the apocrine or eccrine glands. It usually presents as a wellcircumscribed and single subcutaneous masses. Histopathology showed the tumor was located in the dermis, with nests, sheets, and cords of basal-like cells, mucin deposition, and chondroid structures. We herein report a case of CS located in the scalp. CS of the scalp is rare, and its clinical manifestations are similar to those of dermoid cyst, for which it is commonly misdiagnosed.

Prevalence of dermal trypanosomes in suspected and confirmed cases of gambiense human African trypanosomiasis in Guinea.

The skin is an anatomical reservoir for African trypanosomes, yet the prevalence of extravascular parasite carriage in the population at risk of gambiense Human African Trypanosomiasis (gHAT) remains unclear. Here, we conducted a prospective observational cohort study in the HAT foci of Forecariah and Boffa, Republic of Guinea. Of the 18,916 subjects serologically screened for gHAT, 96 were enrolled into our study. At enrolment and follow-up visits, participants underwent a dermatological examination and had blood samples and superficial skin snip biopsies taken for examination by molecular and immuno-histological methods. In seropositive individuals, dermatological symptoms were significantly more frequent as compared to seronegative controls. Trypanosoma brucei DNA was detected in the blood of 67% of confirmed cases (22/33) and 9% of unconfirmed seropositive individuals (3/32). However, parasites were detected in the extravascular dermis of up to 71% of confirmed cases (25/35) and 41% of unconfirmed seropositive individuals (13/32) by PCR and/or immuno-histochemistry. Six to twelve months after treatment, trypanosome detection in the skin dropped to 17% of confirmed cases (5/30), whereas up to 25% of unconfirmed, hence untreated, seropositive individuals (4/16) were still found positive. Dermal trypanosomes were observed in subjects from both transmission foci, however, the occurrence of pruritus and the PCR positivity rates were significantly higher in unconfirmed seropositive individuals in Forecariah. The lower sensitivity of superficial skin snip biopsies appeared critical for detecting trypanosomes in the basal dermis. These results are discussed in the context of the planned elimination of gHAT.

Bullous Cellulitis Due to Coagulase Negative Staphylococcus in Immunocompromised Patient

Introduction: Bullous Cellulitis is initially characterized by erythema and rapid development of bullae. This disease is most often caused by Beta-hemolytic streptococci and rarely by other bacteria such as Coagulase-Negative Staphylococcus (CoNS) type Staphylococcus haemolyticus. Immunocompromised state and history of malignancy are at high risk of infection with this bacterium. Local complications such as bullae can occur in obesity. Case Presentation: A 48-year-old woman with complaints of tensed and loose-walled blisters with a reddish base on the right thigh. The patient had a medical history of Thyroid Cancer, Acute Renal Failure, and Bulging Mass pelvic femur. On physical examination, the patient was unconscious with a ventilator. Dermatological examination of the dextra inferior extremity showed loose bullae with a positive Nikolsky sign and tensed bullae over the erythematous patches, ill-defined, irregular edges, and warm palpable. Laboratory results of leukocytosis, hypoalbumin, and CoNS bacteria from blood culture. An ALT-70 score obtained a total score of 5. Conclusion: Cases of bullous cellulitis are quite rare; cases like this usually occur in patients with an immunocompromised predisposition and obesity. CoNS is a commensal bacteria but, in some cases, could be a pathogen causing cellulitis. Poor prognosis that ends in death could occur in patients who have various complications.

Nevus Unius Lateris (NUL) in a Theree-Year-Old Child Treated by Tretinoin 0.025%, Desoxymethasone 0.25%, and Urea 20% Cream

Background: Linear verrucous epidermal nevus is the most frequent variant of the epidermal nevus classification. Linear verrucous epidermal nevus is characterized by the proliferation of epithelium arranged in a configuration that follows Blaschko's line. Nevus unius lateris (NUL) is a variant of the verrucous epidermal nevus, which has a unilateral distribution of lesions. Lesions are usually found at birth or in the first year of life as brown to grey verrucous papules or papillomatous plaques. The management of NUL is challenging as the results are varied and there is a high risk of recurrence. Purpose: to report a case of NUL and its management, especially in children. Case: A 3-year-old girl presented with brownish spots and multiple small lumps on the left buttock that have extended to the left leg since she was 9-days-old. On dermatologic examination, there were numerous hyperpigmented verrucous papules and plaques along the Blaschko line over the affected area. In this case, the diagnosis of NUL, is based on clinical symptoms and dermoscopy examination showed multiple large brown oval or round structures with hyperpigmented brown border. The patient was treated with combination topical therapy of tretinoin 0.025%, corticosteroid desoxymethasone 0.25%, and urea 20% cream, and the lesion improved within four weeks. Discussion: Epidermal nevus is often cosmetically disturbing. The treatment is still challenging and various, including surgical and non-surgical, but none is ideal and could potentially recur over months or years. dst.

Experience of detecting cancer during the dermatological and dental examination at the dental clinical center

Experience of detecting cancer during the dermatological and dental examination at the dental clinical center

Dermatology in non-human primates: a comprehensive review

There have been limited studies conducted on the anatomy, physiology, and histology of the skin of non-human primates (NHPs). The majority of this research was done by William Montagna and his colleagues in the 1960s and 1970s. Understanding the skin characteristics of NHPs is important for comprehending their biology and behavior, as well as for conducting complementary dermatological examinations and various experiments. This knowledge is particularly important in the diagnosis of specific zoonoses. However, veterinary dermatology for NHPs faces a challenge in obtaining information from both human and veterinary dermatology disciplines, which can lead to diagnostic and therapeutic decisions based on two distinct bodies of literature. Therefore, an integrated approach to dermatology in NHPs is critical, without assuming that the pathology in NHPs is identical to that in humans. This review article aims to highlight the key scientific studies related to the skin of NHPs, with the goal of expanding knowledge about their dermatological characteristics. It also seeks to provide valuable insights for researchers in the field, contributing to a better understanding of dermatology in non-human primates.

Pitiriasis Versikolor

Pityriasis versicolor is an infectious disease that arises due to decreased immunity and is chronic. This disease is caused by the fungus Malassezia sp. which is characterized by hypopigmented or hyperpigmented macules, which can even be accompanied by erythematous and smooth scales. Infection occurs more often in areas with relatively higher temperatures and humidity. Pityriasis versicolor has a worldwide prevalence of up to 50% in tropical countries and 1.1% in cold climates. The incidence of pityriasis versicolor is the same in all races, but is more frequently seen in dark-skinned individuals due to changes in skin pigmentation. This case report describes a 10 year old girl who came with complaints of white spots appearing on her face for 8 months. The initial appearance of the spots is accompanied by itching when sweating. Dermatological examination revealed multiple hypopigmented macules of lenticular to nummular size with well-defined borders with fine scales. On examination with 20% KOH, grouped spores and short hyphae appear like spaghetti and meatballs. Clustered spores are a sign of colonization, while hyphae indicate infection. Pityriasis versicolor therapy consists of administering antifungals which can be done topically and systemically. Furthermore, patients are educated to always keep their skin dry, reduce activities that cause excessive sweating, and wear clothing that is not tight and absorbs sweat.

Prevalence of Sexual Dysfunction among Psoriatic Male Patients

Abstract Background psoriasis is a recurring, cutaneous-articular, chronic inflammatory disease, resulting from immune and proliferative changes that affect the skin and mucosa. The worldwide incidence is 1-3% and the majority of the patients also have emotional difficulties like anxiety, depression, and sexual dysfunction. These issues along with the extent of body surface area affected have an impact on the quality of life, in particular, the sexual life, all aspects of sexual function were negatively affected by the disease process. Aim of the Work to evaluate the prevalence of sexual dysfunction among psoriatic male patients and the role of depression on sexual dysfunction. Patients and Methods the study included 60 male psoriatic patients (married sexually active with no genital abnormalities, malignancy, chronic diseases such as pulmonary, hepatic, renal, hematological, neurologic, psychosis, and similar psychiatric disorders, and not on medications that interfere with erectile function). All patients were subjected to the following: Full medical history taking, local examination of the genitalia, dermatological examination, sexual function evaluation using the Arabic version of IIEF (the international index of erectile function questionnaire) which is a validated questionnaire applied to all cases, and psychiatric evaluation using the Arabic version of Hence Hamilton Depression rating scale (HAM-D) to determine the patient’s level of depression. Results The study revealed a high prevalence of ED (86.7%) and depression (65%) among psoriatic male patients, the ED was statistically significantly affected by the severity, duration of the disease, and genital affection. Also, there was a significant correlation between ED, metabolic parameters, and depression with a significant P value. Conclusion there is a high prevalence of sexual dysfunction and depression among psoriatic male patients. Screening of sexual dysfunction among psoriatic male patients using the IIEF, depression using HAM-D, and metabolic risk factors is recommended for a better quality of life.

Fractional Carbon Dioxide Laser versus Cryotherapy in the Treatment of Alopecia Areata: A Pilot Comparative Study

Abstract Alopecia areata, one or more round bald patches appear suddenly, most often on the scalp. It can affect males and females at any age. The exact mechanism is not yet understood and there is not yet any reliable cure for alopecia areata. Several topical treatments used for alopecia areata are reported to result in temporary improvement in some people. Superficial cryotheray is introduced as a possible treatment for Alopecia Areata with minimal side effects and being less painful. In addition, fractional CO2 laser is introduced as a effective option in AA treatment. Aim of the Study the current study aimed to assess the efficacy and safety of FCO2 laser in comparison to cryotherapy in the treatment of AA. Patients and Methods this study included 22 patients (with patchy AA (at least three patches) of both sexes. Patients were subjected to full history taking, complete general and dermatological examination then digital photography and dermoscopic examination were performed. The three patches in each patient were divided according to therapy used; one patch was treated with Fractional CO2 laser, second one was treated with superficial cryotherapy and the third was left without treatment as control. Results Regarding FCO2 laser treated patches, trichoscopic assessment revealed that BDs, YDs and EMHs count showed significant decrease after treatment compared to before treatment. In addition, SVHs count showed significant increase after treatment compared to before treatment. Concerning cryotherapy treated patches, trichoscopic assessment revealed that BDs, YDs and EMHs count showed significant decrease after treatment compared to before treatment. Also, there was as increase in the TH and SVHs count after treatment in comparison to before treatment, but the results were statistically insignificant. Conclusion Both cryotherapy and fractional CO2 laser therapy are safe and effective modalities in the treatment of AA with superiority for FCO2 laser.

Spectrum of cutaneous lesions in a cohort of patients with neurofibromatosis type 2.

Neurofibromatosis type 2 (NF2) is a rare autosomal dominant syndrome with a predisposition to the development of central nervous system tumors, ophthalmic manifestations, and dermatological lesions. The latter are present in 70-95% of patients and can precede the evolution of other tumors. However, they are not included in the diagnostic criteria and are frequently undervalued during follow-up. An observational cross-sectional study characterizing cutaneous lesions in a cohort of NF2 patients was carried out. Dermatological examinations were performed, and lesions were classified into neural cutaneous tumors (superficial, SNCT, and deep, DNCT), hyperpigmented patches (HyperP), and hypopigmented patches (HypoP). The Dermatology Life Quality Index (DLQI) and EQ-5D questionnaires were applied to evaluate the impact on quality of life. Nineteen patients with a mean age of 36 years were included. Sixteen (84%) patients had cutaneous lesions, mostly developed 10 or more years before the diagnosis. SNCT, DNCT, and HyperP showed similar frequencies (58%). HypoP were observed in only one patient. HyperP developed, on average, earlier than NCT (9.6 vs. 16.5 SNCT, 17.0 DNCT; years). The excised lesions had different histological patterns, including neurofibromas, schwannomas, and a hybrid tumor. Most patients reported a low impact of cutaneous manifestations on the quality of life (DLQI 0 or 1). Cutaneous lesions are frequent in NF2 and may precede the diagnosis by several years. Their identification is important to establish the diagnosis earlier and potentially reduce morbidity and mortality.