Distribution pattern of psoriasis affects sexual function in moderate to severe psoriasis: a prospective case series study.

INTRODUCTION: Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relationship. However, beyond genital psoriasis, the importance of the distribution pattern of the disease has not been considered. AIM: To investigate the role of the distribution pattern of psoriasis in sexual dysfunction. METHODS: A prospective case series study was carried out on 133 patients with moderate to severe psoriasis. MAIN OUTCOME MEASURES: The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index. RESULTS: Forty-four women (mean age 42.0 ± 14.1) and 79 men (mean age 47 ± 11.7) were included in the study. Psoriasis lesions on abdomen, genitals, lumbar region, and buttocks in women and chest, genitals, and buttocks in men were associated with an increase in sexual dysfunction. Multivariate logistic regression analysis showed that the involvement of these specific areas may be independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis. CONCLUSIONS: This is the first study identifying body areas other than genitals as potentially related to sexual dysfunction in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when deciding on treatment for psoriasis patients.

Androgenetic alopecia as an early marker of benign prostatic hyperplasia.

BACKGROUND: Androgenetic alopecia (AGA) and benign prostatic hyperplasia are both androgen-dependent entities that respond to the blocking of 5-alpha-reductase. OBJECTIVES: The objective of this study was to determine whether prostatic volumes and urinary flow changes were higher in patients with early-onset AGA than in healthy control subjects. METHODS: This was an observational case-control study of 87 men: 45 with early-onset AGA diagnosed in the dermatology department and 42 control subjects. End-point variables were prostatic volume, measured by transrectal ultrasound, and urinary flow, measured by urinary flowmetry. A hormone study was performed on all participants, and the International Prostate Symptom Score and International Index of Erectile Function score were determined. RESULTS: The groups did not significantly differ in mean age (cases, 52.7 years vs control subjects, 49.8 years; P = .12). Patients with AGA had significantly higher mean prostate volume (29.65 vs 20.24 mL, P < .0001), International Prostate Symptom Score (4.93 vs 1.23, P < .0001), and prostate-specific antigen value (1.53 vs 0.94 ng/mL, P < .0001) and significantly lower maximum urinary flow (14.5 vs 22.45 mL/s, P < .0001) versus control subjects. Binary logistic regression analysis showed a strong association between the presence of AGA and benign prostatic hyperplasia after adjusting for age, urinary volume, urination time, International Prostate Symptom Score, abdominal obesity, glucose levels, systolic blood pressure, insulin levels, fibrinogen, and C-reactive protein (odds ratio = 5.14, 95% confidence interval 1.23-47.36, P = .041). LIMITATIONS: The study of larger sample sizes would facilitate stratified analyses according to the Ebling type of androgenetic alopecia. CONCLUSION: There is a relationship between the presence of AGA and prostate growth-associated urinary symptoms, likely attributable to their pathophysiological similarity. This study suggests that early-onset AGA may be an early marker of urinary/prostatic symptomatology. Future studies may clarify whether treatment of patients with AGA may benefit the concomitant benign prostatic hypertrophy, which would be present at an earlier stage in its natural evolution.

Variables associated with sun protection behaviour of preschoolers.

Little research has been published on the variables associated with sun protection behaviour in preschoolers. We aimed to define variables associated with sun protection behaviour of a sample of Spanish preschoolers. A cross-sectional observational study was conducted in two stages: 1) the design and validation of the measurement instrument, and 2) its application in a final sample of 100 (60 valid questionnaires) children for bivariate and multivariate binary logistic regression analyses of the data. The sun protection behaviour of the children was most strongly associated with: parental sun protection behaviour, absence or low frequency of sunburn in parents and children, and lower parental perception of obstacles to sun protection. Other significant factors were lower phototype, younger age, shorter sun exposure times and awareness of the sun as a risk factor. The role of social communication programmes, dermatologists and other agents providing information or sun protection advice was contradictory and associated with lower sun protection in some cases. Parental sun protection, absence or lower frequency of sunburns in parents and children, lower phototype of children, knowledge about sun exposure as a risk factor, younger age and lower parental perception of obstacles to their children's sun protection were significantly associated with the sun protection of the children.

Homogeneous blue pattern: A rare presentation in an acral congenital melanocytic nevus.

Acral melanocytic nevi are relatively frequent in the palmoplantar location. In congenital nevi various characteristic dermoscopic patterns have been described, such as reticular and globular patterns, brown pigmented areas, and areas with peripilar depigmentation. However, there are few reports on the dermoscopic pattern of acral congenital nevi. The homogeneous blue pattern is typical of blue nevus and is not typical of acral localization and metastasis of cutaneous melanoma. However, this pattern should be considered characteristic of acral congenital nevus.

[Cutaneous necrosis due to interferon alpha in a patient with melanoma]. / Necrosis cutánea por interferón alfa en paciente con melanoma.

We present the case of a 55-year-old male with melanoma in the right retroauricular region who had cutaneous necrosis only in one of the injection sites after adjuvant treatment with interferon (IFN alpha 2b) according to the Kirkwood proposed regime. Appearance of cutaneous necrosis is a rare condition that has been described in patients treated with different types of IFN.

Necrosis cutánea por interferón alfa en paciente con melanoma / Cutaneous necrosis due to interferon alpha in a patient with melanoma

Presentamos el caso de un varón de 55 años con un melanoma en la región retroauricular derecha que después de un tratamiento quirúrgico y adyuvante con interferón (IFN alfa 2b) según la pauta propuesta por Kirkwood presentó, en el último mes de tratamiento, una necrosis cutánea sólo en uno de los sitios de inyección. La aparición de necrosis cutánea es una situación rara que se ha descrito en pacientes tratados con distintos tipos de IFN

We present the case of a 55-year-old male with melanoma in the right retroauricular region who had cutaneous necrosis only in one of the injection sites after adjuvant treatment with interferon (IFN alpha 2b) according to the Kirkwood proposed regime. Appearance of cutaneous necrosis is a rare condition that has been described in patients treated with different types of IFN

Amputation neuromas after neck surgery.

Traumatic or amputation neuromas are benign tumours formed by a proliferation of Schwann cells, axons and connective tissue elements. They are secondary to the partial or total section of a nerve pathway due to an accidental or surgical trauma. They can form at any site and affect any type of nerve. The presence of amputation neuromas is very frequent in major surgery but rare in simple excisions of skin tumours. We report two cases with neuroma localized in the neck, one after lymph node dissection for melanoma metastasis and the other after excision of a cutaneous melanoma with 3-cm margin on lateral neck. In both cases, the presence of the neuroma mandated a surgical excision to rule out a possible recurrence of melanoma.

Pápulas faciales en un trasplantado renal

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Markers of metastasis in lip cancer.

The incidence of lip cancer in Granada, Spain, is much higher than that recorded in other countries. The natural history of the disease generally includes induction on previous actinic lesions, promotion with local growth of the tumour, and the appearance of metastasis in regional lymph node chains and, exceptionally, via the blood stream. In order to determine the risk factors for metastases, a retrospective hospital-based study was conducted of 251 cases of lower lip cancer diagnosed and treated during a 10-year period from 1985 to 1995. All patients studied had a minimum follow-up of five years. Among the metastasis risk factors considered, only localization in commissure showed statistical significance (p < 0.001).

Tricorrexis nudosa localizada por aplicación compulsiva de minoxidil / Localized trichorrhexis nodosa for compulsive application of minoxidil

Se presenta el caso de una mujer de 23 años de edad con recesión bitemporal del cabello, sometida a tratamiento con minoxidil tópico al 3% desde hacía dos meses. El uso compulsivo del minoxidil provocó la aparición de una tricorrexis nudosa localizada (AU)

El cáncer de piel en la provincia de Granada / Skin cancer in the province of Granada

El cáncer de piel es el grupo de neoplasias malignas más frecuente en la población de piel blanca de todo el mundo, evidenciándose un aumento de su incidencia durante los últimos años. El objetivo de este estudio fue conocer su incidencia en la provincia de Granada y compararla con la de otras áreas geográficas de España y del resto del mundo. Para ello se utilizaron los datos del Registro de Cáncer de Granada del período 1990-1994 y la publicación Cancer Incidence in Five Continents, vol. VII, estudiándose por separado el melanoma maligno (MM) y el cáncer cutáneo no melanoma (CCNM).Se analizaron 2.684 casos de cáncer de piel, que fue el tumor maligno más frecuente en Granada en el período de estudio. El CCNM presentó una mayor frecuencia en los hombres (tasas brutas de 72 por 100.000 hombres frente a 54,7 por 100.000 mujeres) y en personas de edad avanzada. El MM mostró menos diferencias entre hombres y mujeres (4 y 5,4 por 100.000, respectivamente) y una distribución por edades también más homogénea. Entre los 150 registros de cáncer de todo el mundo estudiados, Granada presentó una incidencia de CCNM relativamente elevada y una incidencia media-baja de MM (AU)