Male genital lichen sclerosus and associated symptoms range and severity: Results of a questionnaire study.

Background: Male genital lichen sclerosus (MGLS) is a chronic inflammatory condition most often seen in uncircumcised men. It has an association with squamous cell carcinoma of the penis and causes significant morbidity in many men. It may present with a range of symptoms, notably male dyspareunia. The full range of symptoms in individuals has yet to be elucidated. Aim: To identify the range and severity of patient's symptoms using a questionnaire to quantify symptoms, including sexual function and urinary symptoms. Patients with MGLS were compared against patients diagnosed with other genital skin conditions (non-MGLS). Methods: Retrospective review of patients attending a specialist male genital skin clinic. A questionnaire, where symptoms were ranked between 0 (not present/no effect) and 10 (severe effect) was presented as part of the clinical assessment. Clinical diagnosis of MGLS or non-MGLS was made at the assessment. Results: Sixty four patients attending the clinic completed the questionnaire, and 50 patients were diagnosed with MGLS. Splitting of skin (61.0%), soreness (61.0%), and unusual appearance or colour of penis (57.8%) were the most frequently reported physical symptoms in patients with MGLS. Non-MGLS patients reported these same symptoms in 35.7%, 35.7%, and 50.0% of cases respectively. Conclusion: Administering a simple numeric questionnaire for patients with MGLS has revealed multiple symptoms experienced by most patients. Scoring these symptoms allows the clinician to focus on the problems that most concern the individual patient, rather than just focussing on the physician's assessment of clinical disease.

A Non-Healing Lesion on the Anterior Chest of a Patient Receiving Hemodialysis: A Case Study.

Basal cell carcinoma is the most common type of skin cancer, and patients receiving hemodialysis are at increased risk of developing them. This article describes a case of a patient with a basal cell carcinoma in which the diagnosis was delayed due to the lesion masquerading as granulation tissue at the site of a previous tunnelled hemodialysis catheter. Early detection of basal cell carcinomas is important because delayed detection increases the risk of local invasion and the requirement for more complex surgical management.

An ultrastructural study of chronic chromate hand dermatitis.

Occupational chromate dermatitis is one of the most common occupational diseases, predominantly causing hand eruptions. The ultrastructural manifestations of this condition have not been previously described. In this study, 7 cases of chronic occupational chromate hand dermatitis were investigated. Biopsies were taken from palmar skin and examined using light and electron microscopy. The ultrastructural features of chronic chromate dermatitis are similar to those of acute inflammatory dermatoses, even in the absence of clinical or histological features of an acute inflammatory process. Most changes are probably mechanical in nature and are a result of increasing intercellular oedema. Several features of chronic chromate dermatitis are common to other inflammatory dermatoses, including the presence of marked intercellular oedema of the lower epidermal keratinocytes, the formation of intracellular vacuoles in cells of the lower epidermis and the presence of milder ultrastructural changes in the midepidermis. The study has documented the presence of dendritic, spindle-shaped granular cells in the upper dermis, which have not previously been described in chromate dermatitis. The epidermis in chromate dermatitis appears to have fewer desmosomes when compared with other forms of dermatitis.