Ana Almodovar-Real

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.

Proliferative nodule in melanocytic nevi mimicking deep penetrating nevus

Proliferative nodules can occasionally arise on congenital and acquired melanocytic nevi. At first sight their clinical and pathologic features cause alert to both dermatologist and dermatopathologist. However, proliferative nodules are typically benign, regression is common and there is minimum risk of malignization. We present a new case of proliferative nodule in melanocytic nevi with features of deep penetrating nevus.

Lichen Planus Pigmentosus with Blaschkoid Distribution

A 57-year-old woman presented at a dermatology unit in Granada, Spain, in 2015 with a two-month history of slightly pruritic brown-coloured macular lesions on the trunk and right arm. She was not taking any medications or using cosmetics and had not been exposed to the sun before the onset of the rash. On examination, clearly defined hyperpigmented brown macules were seen on the right submammary region, right hemithorax, right abdomen and right buttock [Figure 1] with an S-shaped appearance, compatible with the pattern of Blaschko lines. Tests for hepatitis B and hepatitis C were negative. A histological examination showed rich lymphocytic infiltrate and melanin incontinence with slight epidermal atrophy and lichenoid reaction with hypergranulosis [Figure 2]. Considering these features, a diagnosis of lichen planus pigmentosus (LPP) with Blaschkoid distribution was proposed. The patient was prescribed topical clobetasol propionate for four weeks. The lesions responded well to the treatment, with significant pigment reduction and improvement of the associated pruritus.

Solitary asymptomatic nodule on the leg.

A 58-year-old man presented with an asymptomatic skin nodule on the left leg for several months. Physical examination showed a well-defined, erythematous nodule (2 cm × 1.5 cm) with a lobulated surface [Figure 1]. Differential diagnoses of squamous cell carcinoma, basal cell carcinoma and cutaneous lymphoma were considered. An excisional biopsy was performed. Histopathology showed pseudoepitheliomatous hyperplasia [Figure 2]. There was a dense, irregular, lymphoid infiltrate with admixture of neutrophils, eosinophils and large, atypical Reed-Sternberg-like cells in the dermis [Figure 3]. Immunohistochemical analysis revealed strong positivity for CD30 [Figure 4]a. Tumor cells were also positive for the cytotoxic marker T-cell intracellular antigen-1 [Figure 4]b, CD3, CD7 and CD4 [Figure 4]c. On the other hand, AE1-AE3, CD8, CD56, CD20, ALK-1, CD5, CD15 and CD25 were all negative. Routine investigations and positron emission tomography-computed tomography study were normal. There was no recurrence after 1 year of follow-up.{Figure 1}{Figure 2}{Figure 3}{Figure 4}

Widespread eosinophilic pustular folliculitis in a nonimmunocompromised patient.

Objective: We present a case of eosinophilic pustular folliculitis, a rare dermatosis which is often associated with HIV infection or internal malignancies. Clinical Presentation and Intervention: We report the case of a 66-year-old man with a medical history of hypertension. Histopathological examination showed a dense follicular inflammatory infiltrate with abundant eosinophils. The clinical response to indomethacin was excellent with no recurrence during the follow-up. Conclusion: The patient responded well to indomethacin treatment.