BACKGROUNDEmerging epidemiological evidence suggests independent associations between psoriasis and metabolic syndrome. Objectives: The aim of the study was to examine the prevalence of metabolic syndrome and its components in patients with psoriasis, and to assess which factors may predict metabolic syndrome in these patients.METHODSA hospital-based, cross-sectional study with 244 psoriatic patients and 163 control subjects with skin diseases other than psoriasis was conducted at the Clinic of Dermatovenerology, Clinical Center of Serbia, Belgrade, from October 2011 to October 2012. Metabolic syndrome was defined using the revised National Cholesterol Education Program Adult Treatment Panel III. Severity of psoriasis was measured by Psoriasis Area and Severity Index and Body Surface Area.RESULTSThe adjusted odds ratios (ORs) and 95% confidence intervals (CI) for psoriasis patients vs. non-psoriasis patients were 2.66 (95% CI, 1.58-4.42) for metabolic syndrome, 3.81 (95% CI, 2.30-6.31) for hypertension, 2.29 (95% CI, 1.39-3.78) for central obesity, 1.92 (95% CI, 1.08-3.41) for hyperglycemia, 1.87 (95% CI 1.18-2.96) for low high-density lipoprotein cholesterol level, and 1.42 (95% CI, 0.87-1.04) for hypertrigliceridemia. We failed to find any statistically significant association between the metabolic syndrome and clinical severity of psoriasis. Later onset and longer duration of psoriasis were predicting factors for metabolic syndrome in our patients. Study limitations: The cross-sectional design of the study does not allow us to draw directional causal inferences concerning the association between psoriasis and metabolic syndrome. Factors such as diet, alcohol consumption or mental health, which have not been evaluated in this study, may be confounders in this relation.CONCLUSIONA higher prevalence of metabolic syndrome and its components in patients with psoriasis than in controls, regardless of disease severity, emphasizes the need for early treatment and follow-up of all psoriatic patients with respect to metabolic diseases.

A case of pseudoepitheliomatous, keratotic and micaceous balanitis (PEKMB) in a 64-year old man is presented. The patient presented with the 2-year history of a slowly enlarging, hyperkeratotic plaque on his glans penis that was compatible with a clinical diagnosis of PEKMB. The lesion has been treated successfully with topical 5-fluorouracil cream, with no evidence of recurrence at 2-year follow-up. Histological examination revealed acanthosis, hyperkeratosis, and pseudoepitheliomatous hyperplasia with no cytological atypia. This rare penile condition was considered pseudomalignant, premalignant, or as a low-grade squamous malignancy. Apart from this patient we comprehensively review previously reported cases, and discuss a possible concept on etiology, diagnosis and treatment of this entity.

BackgroundMucocutaneous manifestations such as oral candidiasis (OC) and seborrheic dermatitis (SD) are very common HIV-related opportunistic events and are usually initial markers of immunodeficiency. AimThe purpose of this study was to evaluate the efficacy of highly active antiretroviral therapy (HAART) in the regression of HIV-associated OC and SD. MethodsIn a prospective study, 120 HIV-infected patients with OC and SD were divided into two groups: HAART-treated patients (group 1, n 5 76) and non-HAART-treated patients (group 2, n 5 44). Non-HAART-treated patients were given antimicrobial therapy. Study subjects were matched for sex, age, risk, and stage of HIV infection. The results were analysed by w 2 test and the Kaplan-Meier method. ResultsAt baseline, OC was evident in 59 (77.7%) of the HAART-treated patients and in 34 (77.3%) of the non-HAART-treated patients, while SD was present in 19 (25.0%) of the HAART-treated patients and in 17 (38.6%) of the non-HAART-treated patients. After a median follow-up period of 22 months, regression of OC and SD occurred in 49 (83.1%) and 16 (84.2%) of the HAART-treated patients, respectively. In the control group, regression of OC and SD occurred in only five (14.7%) and seven (41.2%) patients, respectively, during the same period. ConclusionsHAART showed greater efficacy than standard antimicrobial therapy for the treatment of OC and SD in HIV-infected patients. Oral candidiasis is the most common oral feature of opportunistic fungal infection, occurring in 90% patients during the course of HIV disease, and is an important criterion in most clinical staging systems for HIV infection [4,7]. SD is a common skin condition among HIV-infected persons, with a prevalence of 7-50%, and is also closely related to the stage of HIV infection [6,8].The introduction of highly active antiretroviral therapy (HAART) has resulted in a dramatic decline in the incidence of opportunistic infections. HAART has led to reductions in disease progression and mortality [5,[9][10][11][12][13].The aim of the study was to evaluate the efficacy of HAART regarding the regression of HIV-associated OC and SD. A total of 120 HIV-infected patients (53 women and 67 men; ages ranging from 9 to 67 years) with mucocutaneous manifestations were divided into two groups: 76 patients treated with HAART (59 OC and 19 SD) and 44 non-HAART-treated patients (34 OC and 17 SD; control group) treated with antimicrobial therapy.Diagnoses of OC and SD were based on clinical manifestations (Figs 1 and 2) and confirmed using smears taken from lesions and examined by potassium hydroxide preparation for Candida albicans, plus fungal cultures to identify the causitive organism, and for Pityrosporum ovale, at the beginning of the study and during the follow-up period.The HAART regimen consisted of one protease inhibitor (saquinavir, nelfinavir, ritonavir or indinavir) and two reverse transcriptase inhibitors (zidovudine, didanosine, stavudine, lamivudine or abacavir). The HAART-treated patients did not receive standard derm...

The results confirm a high rate of contact (poly)sensitization in patients with CVLU and local variability in allergen prevalence.

Two oil-in-water formulations, containing equal amounts of apigenin-enriched chamomile flower extracts, for potential use as topical antiinflammatory agents, were prepared and their physicochemical properties evaluated. A pilot clinical study was then carried out to assess patient acceptability and efficacy. The creams were either non-liposomal or liposomal. The liposomal formulations were more viscous, thus producing superior release characteristics in vitro. The clinical study also showed that the liposomal creams were, as antiinflammatory agents, slightly more effective in vivo than the non-liposomal formulations. These results suggest that there is scope for the further development of even more effective and safer alternatives to corticosteroids.