No abstract

No abstract

Follicular psoriasis is a common yet under reported entity. Major dermatology textbooks fail to emphasise and even neglect this important diagnosis and since its original description in 1920 there have been only three reports in the published literature. As a result the diagnosis is seldom entertained by dermatology trainees in the differential diagnosis of a folliculocentric skin disease. We present a case of follicular psoriasis which was initially mis-diagnosed as lichen planopilaris and summarise the key features of this neglected entity. Our aim is to highlight awareness of this disorder and we also propose that the follicular variant be included as a psoriasis subtype in standard dermatology textbooks.

Persistence of HIV through integration into host DNA in CD4 + T cells presents a major barrier to virus eradication. Viral integration may be curtailed when CD8 + T cells are triggered to kill infected CD4 + T cells through recognition of histocompatibility leukocyte antigen (HLA) class I-bound peptides derived from incoming virions. However, this has been reported only in individuals with ''beneficial'' HLA alleles that are associated with superior HIV control. Through interrogation of the pre-integration immunopeptidome, we obtain proof of early presentation of a virion-derived HLA-A*02:01-restricted epitope, FLGKIWPSH (FH9), located in Gag Spacer Peptide 2 (SP2). FH9-specific CD8 + T cell responses are detectable in individuals with primary HIV infection and eliminate HIV-infected CD4 + T cells prior to virus production in vitro. Our data show that non-beneficial HLA class I alleles can elicit an effective antiviral response through early presentation of HIV virion-derived epitopes and also demonstrate the importance of SP2 as an immune target.

We describe two patients who received haematopoietic stem cell marrow transplantation, and developed male genital lichen sclerosus (MGLSc), one of whom also had squamous carcinoma in situ (Bowen disease). MGLSc has previously been associated with graft-versus-host disease. Various aetiological factors for LSc have been proposed, including a role for chronic occluded epithelial exposure to urine. A number of factors imply that the risk of malignant transformation in this bone marrow transplant group is likely to be higher than the overall figure of 2-9% cited for MGLSc. It is vital, therefore, that clinicians involved in the care of those with haematological malignancies are adequately prepared to examine the genitals of their patients, and to recognize and refer any suspect penile lesions.