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Background Genital involvement in atopic dermatitis(AD) can have a significant impact on the patient’s quality of life. However, inspection of genital areas is not usually conducted during routine examination and patients may be reluctant to inform the clinician or show this area.Objective to evaluate the efficacy of tralokinumab in AD patients with genital involvement.Methods Adult patients with moderate/severe AD and genital involvement receiving tralokinumab have been analyzed. Primary endpoints were EASI, DLQI, PP-NRS, genital-IGA (g-IGA) and genital itching (GI) at week 16.Results out of 48 patients with moderate/severe AD under treatment with tralokinumab, 12 patients (25%) showed a genital involvement. Seven patients reported itching in the genital area (58%), while none reported a positive history of genital infections. Median scores at T0 were EASI 17.5, PP-NRS 8 and DLQI 14. After 16 weeks of treatment, we observed a median EASI of 3, a median PP-NRS of 1 and a median DLQI of 1. Finally, concerning the genital response, after 16 weeks of treatment, we observed a statistically significant decrease in mean GI and g-IGA scores.Conclusion despite the small size of our sample, tralokinumab can be considered as a valid treatment option for AD with genital involvement.

Background: Genital involvement in atopic dermatitis(AD) can have a significant impact on the patient's quality of life. However, inspection of genital areas is not usually conducted during routine examination and patients may be reluctant to inform the clinician or show this area. Objective: to evaluate the efficacy of tralokinumab in AD patients with genital involvement. Methods: Adult patients with moderate/severe AD and genital involvement receiving tralokinumab have been analyzed. Primary endpoints were EASI, DLQI, PP-NRS, genital-IGA (g-IGA) and genital itching (GI) at week 16. Results: out of 48 patients with moderate/severe AD under treatment with tralokinumab, 12 patients (25%) showed a genital involvement. Seven patients reported itching in the genital area (58%), while none reported a positive history of genital infections. Median scores at T0 were EASI 17.5, PP-NRS 8 and DLQI 14. After 16 weeks of treatment, we observed a median EASI of 3, a median PP-NRS of 1 and a median DLQI of 1. Finally, concerning the genital response, after 16 weeks of treatment, we observed a statistically significant decrease in mean GI and g-IGA scores. Conclusion: despite the small size of our sample, tralokinumab can be considered as a valid treatment option for AD with genital involvement. [ABSTRACT FROM AUTHOR]

During the Army recruitment process, the body of potential soldiers were examined by medical experts looking for indications of military unsuitability. The doctors had to inspect every part of the body, including the genitals. Certain pathologies and defects were indeed considered to be incompatible with military life. While practical considerations guided this exploration, the examination also reflected a certain masculine normativity whose characteristics were entirely dictated by the specific needs of the military institution. The inspection of the reproductive organs by military doctors remained purely anatomical and did not take into account the candidate’s sexual performance or ability to reproduce. In this respect, the conception of masculinity attached to this examination differed from others. It differed from that of ordinary physicians, who routinely considered other criteria than the appearance of the genitals to define the characteristics of the male body. It also differed from that of the recruits themselves, who frequently assimilated this medical examination to a test of their sexual potency.

Mucosal melanoma malignum (mMM) is a rare and aggressive malignancy that carries a poor prognosis. Most commonly, it develops on the mucous membranes in the head and neck region, and within the genitalia. Because of its anatomical location and absence of early symptoms, diagnosing mucosal melanoma malignum presents significant challenges. Consequently, the disease is usually diagnosed at an advanced stage. Dermoscopy is a helpful tool in the early diagnosis of mucosal melanoma malignum. Risk factors for mucosal melanoma malignum are poorly understood so far, but exposure to ultraviolet light is not known to increase the risk of developing the disease. The overall 5-year survival rate for mucosal melanoma ranges from 0% to 45%, with an average survival of 2 years. Early detection is crucial for favourable prognosis.

The male genitals of internal fertilisers evolve rapidly and divergently, and sexual selection is generally responsible for this. Many sexually selected traits are condition‐dependent—with their expression dependent upon the resources available to be allocated to them—as revealed by genetic or environmental manipulations of condition. However, it is not clear whether male genitals are also condition‐dependent. Here we manipulate condition in two ways (via inbreeding and diet) to test the condition‐dependence of the genital arch of Drosophila simulans. We found that genital size but not genital shape suffered from inbreeding depression, whereas genital size and shape were affected by dietary manipulation of condition. The differential effects of these treatments likely reflect underlying genetic architecture that has been shaped by past selection: inbreeding depression is only expected when traits have a history of directional selection, while diet impacts traits regardless of historical selection. Nonetheless, our results suggest genitals can be condition‐dependent like other sexually selected traits. [ABSTRACT FROM AUTHOR]

Mucosal melanoma malignum (mMM) is a rare and aggressive malignancy that carries a poor prognosis. Most commonly, it develops on the mucous membranes in the head and neck region, and within the genitalia. Because of its anatomical location and absence of early symptoms, diagnosing mucosal melanoma malignum presents significant challenges. Consequently, the disease is usually diagnosed at an advanced stage. Dermoscopy is a helpful tool in the early diagnosis of mucosal melanoma malignum. Risk factors for mucosal melanoma malignum are poorly understood so far, but exposure to ultraviolet light is not known to increase the risk of developing the disease. The overall 5-year survival rate for mucosal melanoma ranges from 0% to 45%, with an average survival of 2 years. Early detection is crucial for favourable prognosis. [ABSTRACT FROM AUTHOR]

This article develops a new phenomenological account of the shame people typically tend to feel when seen naked by others. Although shame at nakedness is a paradigmatic and widespread form of shame, it has been under-explored in the literature on shame. The central thesis of the article is that shame at nakedness is rooted in our desire for social affirmation and constituted by our capacity for social self-consciousness. I argue that our ability to sense how others see us and judge us gives rise to a dynamic tension between our effort to control our public self-presentation and the experience of being exposed to others in an uncontrolled manner. What makes us prone to feel shame or shame anxiety at being seen naked is that we feel that we have revealed our naked and true self as potentially or actually shameful and that our public persona has been undermined. Furthermore, the vulnerability and lack of control that are part and parcel of naked exposure can be a source of shame. In my analysis, shame at nakedness encompasses both literal bodily nakedness and other kinds of uncontrolled and unguarded exposure. The article also offers an argument as to the roots of the more or less ubiquitous tendency to feel shame at exhibiting one's genitals in public. I develop my account through critical engagements with the main contemporary attempts to account for shame at nakedness, critiquing their insufficiencies and reframing their insights. [ABSTRACT FROM AUTHOR]

While thermal injuries to the external genitalia occur less often than burns to the trunk and extremities, such injuries can potentially leave patients with devastating lifelong sequelae. Though much is known about treating burns in commonly exposed areas of the body, there is a lack of agreement concerning the management of genital thermal injuries. In this review, we seek to synthesize the past and existing literature into a clear analysis while reviewing current recommendations and new developments in the management of genital thermal injuries of the penis and scrotum. Specifically, recommendations for managing genital burns are discussed, including the role of urinary and fecal diversion, debridement, use of skin grafts, and flap coverage choice. Finally, less common thermal injuries, such as frostbite of the genitalia, are discussed.

Localized provoked vulvodynia (LPV) is a chronic pain condition without an identifiable cause that is localized to a portion of the vulva and provoked by pressure or touch. LPV is a commonly occurring but poorly understood condition lacking consensus on management. This scoping review used Arksey and O'Malley's approach to identify and evaluate literature published between 2010 and 2023 that addressed the question: What is the current evidence on the efficacy or effectiveness of pharmacological treatments in the management of LPV? This review evaluated 18 papers reporting on the efficacy or effectiveness of oral, topical, and injectable medications. Seven of the studies were randomized controlled trials. Oral gabapentin and oral desipramine showed some improvement in sexual function compared to placebo. Small sample sizes and methodological issues limited confidence in interpreting findings. Pain was reduced in descriptive studies of tricyclic antidepressants, milnacipran, injectable anesthetics, and botulinum toxin. Where pain did not improve with treatment, some oral medications improved participants' mood and sexual function. Some topical agents may be effective in reducing peripherally mediated neuropathic pain. Botulinum toxin was the most well-studied injectable but yielded mixed outcomes related to pain, quality of life, and sexual function. There is a lack of convincing evidence to draw conclusions about the efficacy or effectiveness of pharmacological therapies for LPV. The breadth of therapies for treating LPV warrants the development of evidence-based, consensus guidelines for measuring treatment outcomes and improving comparisons across studies. Recommendations for research include addressing methodological shortcomings and diversifying the participant pool to increase the generalizability of findings. [ABSTRACT FROM AUTHOR]

Although they are ordinary and almost everyone has them, genitals are riddled with controversies, taboos and anxieties. Despite their social and cultural importance, genitalia have been left out of systematic analysis and research in the context of social sciences and humanities. They are most often positioned in terms of dualisms that create, support and strengthen social distinctions, hierarchies and asymmetries. Transcending the essentialist gender ideas and binaries attributed to human bodies opens up space for new understandings of genitalia in movement, transformation and transition. The key question is: how do culture and media intersect/work through genital transformations? The papers featured here provide inspiring, innovative and research-stimulating responses to the complex presence and representation of genitalia through various media (online forums, novels, video art, performance art, television drama, reality television, mainstream news, feature film and vlogs). Each paper, as well as the entire thematic issue, represents a contribution to the further development of genital studies and strengthens the multidisciplinary questioning of genitalia, power, gender, differences, transgression and resistance. [ABSTRACT FROM AUTHOR]

A 14-year-old boy presented with a history of non-tender, subcutaneous coalescing nodules located on the ventral-lateral aspects of the penis shaft for one year. Laboratory investigations for blood count and autoimmunity were within normal limits. Complete excision was performed, and on histology, the dermis showed necrobiotic material composed of altered collagen bundles, surrounded by a palisade of histiocytes and scattered lymphocytes, thus allowing a diagnosis of subcutaneous granuloma annulare. Only 18 published cases reported penile granuloma annulare. Medical management was advocated in 7/18 cases, either as a first-line or adjuvant therapy where surgery was not radical. Three patients received high-potency local steroids: two cases underwent adjuvant sessions of intralesional triamcinolone, and one patient received pentoxifylline orally. Surgery should be considered a second-line option since 5/8 of treated cases eventually recurred. The pentoxifylline-treated case witnessed a relapse after drug discontinuation, while topical steroids lead to complete recovery without relapses.

Introduction: Psoriasis is a common chronic, immune-mediated, inflammatory skin disease that in certain localization results difficult to treat. Psoriatic lesions in difficult-to-treat areas might be hardly managed as no standardized therapeutic approach and the application of topical treatments might have marred limitations. Systemic agents, including biologic therapies, have been proven effective in treating this subgroup of patients. In particular, current evidence has shown beneficial effects with the use of brodalumab, a fully human IgG2 monoclonal antibody antagonizing the IL-17 receptor A subunit (IL-17RA). Objectives: The aim of this narrative review was to collect published data about efficacy and safety of brodalumab in the treatment of psoriasis occurring in difficult-to-treat areas. Methods: Data on brodalumab effectiveness and safety deriving from both trials and real-world setting that had been published in the last 15 years were collected for this review, together with clinical findings issued during international meetings. Results: In phase 3 trials, brodalumab demonstrated to be effective in promoting a rapid response in scalp psoriasis as well as in generalized pustular psoriasis and erythrodermic psoriasis. Nail psoriasis demonstrated marked clinical improvement after treatment with brodalumab. Amelioration of palmoplantar psoriasis was also described in brodalumab-treated patients. Various retrospective real-world studies reported a complete clearance of psoriatic lesions in difficult-to-treat areas, including genitalia, through short-term brodalumab treatment. Conclusions: Brodalumab, combining rapid and sustained efficacy with a favorable safety profile, may be a valid therapeutic option for severe variants of psoriasis as well as for psoriasis localized in difficult-to-treat areas.

A 14-year-old boy presented with a history of non-tender, subcutaneous coalescing nodules located on the ventral-lateral aspects of the penis shaft for one year. Laboratory investigations for blood count and autoimmunity were within normal limits. Complete excision was performed, and on histology, the dermis showed necrobiotic material composed of altered collagen bundles, surrounded by a palisade of histiocytes and scattered lymphocytes, thus allowing a diagnosis of subcutaneous granuloma annulare. Only 18 published cases reported penile granuloma annulare. Medical management was advocated in 7/18 cases, either as a first-line or adjuvant therapy where surgery was not radical. Three patients received high-potency local steroids: two cases underwent adjuvant sessions of intralesional triamcinolone, and one patient received pentoxifylline orally. Surgery should be considered a second-line option since 5/8 of treated cases eventually recurred. The pentoxifylline-treated case witnessed a relapse after drug discontinuation, while topical steroids lead to complete recovery without relapses. [ABSTRACT FROM AUTHOR]

Undoubtedly, the human body harbors trillions of microbes of different kinds performing various physiological activities, such as priming the immune system, influencing host metabolism, and improving health by providing important metabolites such as short-chain fatty acids. Although the gut is considered the "microbial organ" of our body as it hosts the most microbes, there are microbes present in various other important anatomical locations differing in numbers and type. Research has shown the presence of microbes in utero, sparking a debate on the "sterile womb" concept, and there is much scope for more work in this area. It is important to understand the early-life microbiome colonization, which has a role in the developmental origins of health and disease in later life. Moreover, seminal studies have indicated the presence of microbes beyond the gut, for example, in the adipose tissue and the liver. However, it is still unclear what is the exact source of these microbes and their exact roles in health and disease. In this review, we appraise and discuss emerging microbiome areas of research and their roles in metabolic health. Further, we review the importance of the genital microbiome in early-life microbial interactions. [ABSTRACT FROM AUTHOR]

The social economic and medical demographic significance of malignant neoplasms in women is determined by the high morbidity and mortality rates of the female population of working and reproductive periods. Visual forms of malignant neoplasms in women, which are diagnosed in the early stages, can be treated effectively. The objective: to determine and analyze the indicators of diagnosis of visual malignant neoplasms forms of the genital organs in late stages and during preventive examinations in women of Chernihiv region in the dynamics of five years. Materials and methods. The official statistical data for 2017–2021 of administrative territories of Chernihiv region and Ukraine were used. The medical-statistical method and the method of structural logical analysis were used. Results. It was established that the rate of female malignant breast neoplasms which were diagnosed in late stages during 2017- 2021 has a tendency to decrease (24.9-23.9 %), while the frequency of malignant neoplasms of the cervix that were detected in late stages, has an upward trend (43.6–43.8 %). At the same time, only 29.0 % of breast malignant neoplasms and 19.1 % of malignant neoplasms of the cervix were diagnosed during preventive examinations in 2021. The rate of malignant neoplasms diagnosis of the above locations during preventive examinations in the study years (2017– 2021) decreased. All the indicated indicators have significant differences in the administrative territories of the region. Conclusions. In Chernihiv region of Ukraine in 2017–2021, a high level of diagnosis of visual malignant neoplasms forms of the genital organs in late stages and a low level of detection of malignant neoplasms during preventive examinations were established, which requires improvement of preventive measures both at the regional level and at the level of administrative territory. [ABSTRACT FROM AUTHOR]

Our understanding of the genetic architecture of phenotypic traits has experienced drastic growth over the last years. Nevertheless, the majority of studies associating genotypes and phenotypes have been conducted at the ontogenetic level. Thus, we still have an elusive knowledge of how these genetic-developmental architectures evolve themselves and how their evolution is mirrored in the phenotypic change across evolutionary time. We tackle this gap by reconstructing the evolution of male genital size, one of the most complex traits in insects, together with its underlying genetic architecture. Using the order Hemiptera as a model, spanning over 350 million years of evolution, we estimate the correlation between genitalia and three features: development rate, body size, and rates of DNA substitution in 68 genes associated with genital development. We demonstrate that genital size macro-evolution has been largely dependent on body size and weakly influenced by development rate and phylogenetic history. We further revealed significant correlations between mutation rates and genital size for 19 genes. Interestingly, these genes have diverse functions and participate in distinct signaling pathways, suggesting that genital size is a complex trait whose fast evolution has been enabled by molecular changes associated with diverse morphogenetic processes. Our data further demonstrate that the majority of DNA evolution correlated with the genitalia has been shaped by negative selection or neutral evolution. Thus, in terms of sequence evolution, changes in genital size are predominantly facilitated by relaxation of constraints rather than positive selection, possibly due to the high pleiotropic nature of the morphogenetic genes. [ABSTRACT FROM AUTHOR]

This study sought to identify Iranian preschool children's (N = 318) knowledge of genital and non-genital body parts. Assessment consisted of children naming selected external body parts in drawings of same-sex counterparts. Results indicated that almost all children knew the correct terms for their non-genital body parts, but few knew the correct terminology for their genitals. Many used slang terms and some appeared embarrassed or reluctant to reply (girls were more likely than boys not to respond). No statistically significant difference between the sex of children in knowledge of correct names of all genitals emerged. Boys knew the correct name of their genitalia (penis) significantly more than girls. Results indicated children are learning the names of their body parts but not their genitals, perhaps indicative of a lack of sexual health education that may be representative of the conservative culture in Iran. It is critical for young children to learn about their genitals as this knowledge provides the foundation for subsequent sex education and facilitates discussion about bodily safety to prevent sexual abuse. When children learn these names, it can facilitate disclosure of abuse and can assist those working with young children in medical settings, child protection and legal arenas. [ABSTRACT FROM AUTHOR]

Background: Chikungunya is a viral disease that is transmitted by mosquitoes. It is characterized by an acute onset of fever and severe arthralgia. Methods: We describe six cases of acute and post-acute chikungunya in which viral RNA was detected in semen. Conclusions: The most prolonged detection period was 56 days after illness onset. We attempted to cultivate positive semen samples, but virus isolation was unsuccessful in all cases. [ABSTRACT FROM AUTHOR]

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Masturbation is a common human behaviour. Compared to other unimanual behaviours it has unique properties, including increased sexual and emotional arousal, and privacy. Self-reported hand preference for masturbation was examined in 104 left-handed and 103 right-handed women, and 100 left-handed and 99 right-handed men. Handedness (modified Edinburgh Handedness Inventory, EHI), footedness, eyedness, and cheek kissing preferences were also measured. Seventy nine percent used their dominant hand (always/usually) for masturbation, but left-handers (71.5%) were less consistently lateralized to use their dominant hand than right-handers (86.5%). Hand preference for masturbation correlated more strongly with handedness (EHI), than with footedness, eyedness, or cheek preference. There was no difference in masturbation frequency between left- and right-handers, but men masturbated more frequently than women, and more women (75%) than men (33%) masturbated with sex aids. For kissing the preferred cheek of an emotionally close person from the viewer's perspective, left-handers showed a left-cheek preference, and right-handers a weaker right-cheek preference. The results suggest that hemispheric asymmetries in emotion do not influence hand preference for masturbation but may promote a leftward shift in cheek kissing. In all, masturbation is lateralized in a similar way to other manual motor behaviours in left-handed and right-handed men and women. [ABSTRACT FROM AUTHOR]

Undoubtedly, the human body harbors trillions of microbes of different kinds performing various physiological activities, such as priming the immune system, influencing host metabolism, and improving health by providing important metabolites such as short-chain fatty acids. Although the gut is considered the “microbial organ” of our body as it hosts the most microbes, there are microbes present in various other important anatomical locations differing in numbers and type. Research has shown the presence of microbes in utero, sparking a debate on the “sterile womb” concept, and there is much scope for more work in this area. It is important to understand the early-life microbiome colonization, which has a role in the developmental origins of health and disease in later life. Moreover, seminal studies have indicated the presence of microbes beyond the gut, for example, in the adipose tissue and the liver. However, it is still unclear what is the exact source of these microbes and their exact roles in health and disease. In this review, we appraise and discuss emerging microbiome areas of research and their roles in metabolic health. Further, we review the importance of the genital microbiome in early-life microbial interactions.

Objective: Historically, the clitoris has often been tarnished with a shroud of shame and has been demeaned as not clinically relevant. As such, empirical data regarding the anatomy of clitoral structures is lacking. Therefore, the aims of this study are to collate data on the anatomy of the clitoris, in addition to highlighting the lack of representation within the literature. Methods: A systematic review and meta-analysis was performed on Ovid Medline and Embase. Descriptions and measurements of clitoral structures were extracted from cadaveric, patient and medical imaging studies, in addition to 32 anatomical textbooks. A meta-analysis was performed to calculate the average measurement and range of clitoral structures, and a statistical analysis was performed to compare these measurements from different study modalities. Results: Within the anatomical textbooks, the word 'penis' was mentioned 2.6 times more than the word 'clitoris' and discrepancies in anatomical descriptions were elucidated. Nine textbooks reported the distance between the external urethral meatus and the clitoris (20.00--30.00 mm) and only two reported the combined length of the glans and body (20.00 mm; 30.00--40.00 mm). Data was extracted from 31 relevant studies. The average length and range of the glans (8.60 mm; 0.5--35 mm), body (28.14 mm; 13.00 mm--59.00 mm), crura (48.43 mm; 25.00 mm--90.00 mm), bulb of the vestibule (54.00 mm; 13.00 mm--70.00 mm), prepuce 23.84 mm; 5.00 mm--40.00 mm) and frenulum (9.5 mm; 5.00 mm--12.00 mm) was calculated. No statistical difference was found between the different imaging modalities utilized. Conclusion: The clitoris is an underrepresented structure in medical textbooks. The normal variations in clitoral measurements should be disseminated to healthcare professionals and the public. [ABSTRACT FROM AUTHOR]

Koro syndrome is a multi-tiered disease presenting as an overwhelming belief that one's sex organs are shrinking into their body. Moderate to severe anxiety attacks are associated with the condition, along with a fear of imminent death. Koro is often culturally related and is most seen as an epidemic form in East and Southeast Asia, although it can present anywhere worldwide in its sporadic form. The condition typically affects young males who believe in sex-related myths, and many individuals can co-present with anxiety, depression, or even psychosis. Although most presentations of Koro are self-limiting, the condition is harmful for one's self-esteem and quality of life, and some individuals may go through extreme, physically injurious measures to prevent genital retraction. Treatments include the use of psychotherapy that has a sex education component, especially if the patient believes in culturally rooted myths. In sporadic Koro, it is believed that if the primary psychiatric disorder is treated with anxiolytics, antidepressants, sedatives, or psychotics, the secondary Koro-like symptoms will also fade. Additional investigation on the prevalence, pathogenesis, factors that correlate with treatment efficacy are needed to fully understand Koro syndrome.