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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]

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]

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.

BackgroundFemale genital self-image is an important aspect of psychosocial and sexual health. The Female Genital Self-Image Scale (FGSIS) is a validated instrument that has been used to characterize women's level of genital dissatisfaction.AimIn this report, we assess genital dissatisfaction using the FGSIS in a nationally representative sample of U.S. women.MethodsWe conducted a nationally representative survey of non-institutionalized adults aged 18-65 years residing in the United States. The survey included questions about demographics, sexual behavior, and the FGSIS.OutcomesDemographic characteristics were found to significantly correlate to women's perceived genital dissatisfaction.ResultsIn total, 3,372 women completed the survey and 3,143 (93.2%) completed the FGSIS. The mean age was 46 years, and there was broad representation across the United States in terms of age, education, and location. On bivariate analysis, women's genital dissatisfaction was significantly correlated to their age, race, location, and education. Women who were sexually active were less likely to report genital dissatisfaction than women who were not sexually active (76% vs 62%, respectively, P < .001). The frequency of sexual activity was negatively correlated with genital dissatisfaction (P = .002). Women who reported genital dissatisfaction were less likely than those who reported satisfaction to engage in receptive vaginal sex (83% vs 88%, respectively, P = .03). There were no other significant associations between genital dissatisfaction and types of sexual activity. On multivariate analysis, women were less likely to report genital dissatisfaction if they were older, of black race, had an education level of high school or above, and/or lived in the Northeastern or Midwestern United States. There was no association between genital dissatisfaction and relationship status or gender of sexual partner.Clinical translationFemale genital dissatisfaction may be related to age, race, education, and geography.ConclusionsThis is the first nationally representative sample of U.S. women focusing on genital and self-image and dissatisfaction. These data may not apply outside the United States. These data may help providers who provide information for women and manage concerns related to genital self-image. Rowen TS, Gaither TW, Shindel AW, et al. Characteristics of Genital Dissatisfaction Among a Nationally Representative Sample of U.S. Women. J Sex Med 2018;15:698-704.

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]

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]

Psoriasis often affects specific locations such as the nail apparatus, scalp, hands, feet, and genital areas. It usually coexists with severe plaque psoriasis. However in some cases only these areas may be affected, causing a significant deterioration of the patient’s quality of life, low self-esteem and depression. In the absence of effects of a topical treatment (glucocorticosteroids in monotherapy or combined with calcipotriol, keratolytic agents, phototherapy, calcineurin inhibitors) and standard systemic therapy (i.e., retinoids, methotrexate and cyclosporin), biological drugs are often used, even though the PASI score does not exceed 10. Interleukin-17 inhibitors and interleukin-23 inhibitors, are the most adequate biological drugs for isolated psoriasis in these special anatomic locations

Copyright of Revista de Ciencias Sociales (13159518) is the property of Revista de Ciencias Sociales de la Universidad del Zulia Venezuela and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Dermatophyte is a group of keratinophilic fungi that cause various skin lesions depending on the affected area. Dermatophytosis is usually diagnosed by clinical manifestation and confirmed by direct microscopy or fungal culture. There might be diagnostic difficulty with the presence of atypical dermatophytosis. Atypical dermatophytosis presents with clinical appearances ranging from eczematous, psoriasiform, pustular lesions, and others, that interferes with early diagnosis and disturbs patient’s life quality. Genital dermatophytosis is an uncommon presentation of cutaneous fungal infection; moreover, its manifestation without the involvement of the inguinal area, and simulating wart is a rare sign. In this study, we introduce a rare case of dermatophytosis with a wart-like appearance that was restricted to the skin of the genitalia. Case Presentation: A 24-years-old woman was referred to the academic dermatology clinic of Boo- Ali SINA Hospital in Sari, Iran, in November 2019 with a 9-month complaint of verrucous and pruritic plaque in the genital area that previously misdiagnosed as wart with no response to treatment. The dermatologist requested a review of the previous pathology documents for diagnosing dermatophytosis. The pathologists reexamined the relevant paraffin-embedded skin tissue block of the patient. By Periodic acid-Schiff staining, some fungal elements had been found in the horny layers of the epidermis, so dermatophytosis was confirmed. Based on this diagnosis, terbinafine was prescribed and the patient responded well to this treatment after four weeks. Conclusion: Although the occurrence of genital dermatophytosis with the verrucous appearance and without involvement of groin is a rare finding, it should be considered in the differential diagnosis. In each case suspected of genital dermatophytosis, direct examination or fungal culture for definite diagnosis and prevention of delay in the appropriate treatment is required.

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.

This article represents research on an obscene Ukrainian folklore text published by Fedor. Vovk. Its possible relation to the verse fairy tale, “Nikita the Tzar, and his Forty Daughters”, by Aleksandr S. Pushkin is considered. The elements of the text are given Slavic folklore parallels, which enables making a conclusion about the clearly folk origin of the creative product. The following question is raised: can the text under research possibly be a distant reverberation of the Slavic etiological myth about how women acquired genitals? While such myths might have pagan roots, a suggestion is made that pagan gods were the prototypes of the main characters in the Ukrainian text. Thus, the text, recorded as an obscene joke, can supplement the collection of aetiological myths and legends about how the original people acquired genitals.

Penile squamous cell carcinoma is a rare malignancy seen more frequently in developing nations. Metastasis occurs in a predictable manner, with superficial lymph node involvement occurring first, followed by deep lymph node involvement, and then distant spread. Brain, lung, liver, and bone are the typical sites of distant metastasis. We present the unusual case of an 81-year-old man with penile squamous cell carcinoma requiring total penectomy who developed a confluent red to violaceous, indurated suprapubic plaque with satellite papules and bulky inguinal lymphadenopathy. The shield-like clinical presentation and infiltrating strands and cords on histology resembled carcinoma en cuirasse, a rare form of cutaneous metastasis frequently associated with breast cancer but not reported with penile squamous cell carcinoma.

Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer. Most BCCs are found on areas of UV-damaged skin, The study of BCCs of sun-protected regions, however, suggests a more complex pathogenesis. We present a case of BCC of the perineum in a man with no previous history of skin cancer. This is the first report of BCC in this region and one of a small body of cases arising on or near the genital and perianal regions.

Copyright of Dermatology Review / Przeglad Dermatologiczny is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bartsocas-Papas Syndrome (BPS) is a very rare autosomal recessive syndrome characterised by marked craniofacial deformities, multiple pterygia of various joints, limb and genital abnormalities. It is mostly associated with mutation in the gene encoding Receptor Interacting Serine/Threonine Kinase 4 (RIPK4) required for keratinocyte differentiation. The syndrome is generally lethal and majority of babies die in-utero or in the early neonatal period. This is a report about a neonate born with characteristic clinical features of BPS including severe craniofacial and ophthalmic abnormalities, limb deformities and multiple pterygia at popliteal, axillary and inguinal region. The baby had respiratory distress at birth and was managed conservatively on Continuous Positive Airway Pressure (CPAP)/Oxygen hood and injectable antibiotics for two weeks and then referred for further work-up to a tertiary hospital. The parents took the baby home against the advice of the treating doctors and she subsequently died after 10 days. BPS is associated with high mortality and so all efforts should be directed towards diagnosing it early antenatally when termination of pregnancy is a viable option. This is possible by having a high index of suspicion in couples with consanguineous marriages or with a positive family history.

In recent years, the growth of urogenital infections, often transforming into chronic forms, is one of the most common causes of reproductive damage in women. The aim of the research was to study the structure of immune dysfunctions in patients with chronic urogenital infection. A one-stage observational study of 80 women of reproductive age with chronic urogenital infections was carried out. The control group consisted of 40 healthy women-donors. The main outcome of the study was the severity of the immunocomprometry of the female. The contents of different subpopulations of lymphocytes (CD3+, CD4+ and CD8+ T-lymphocytes, CD20+ B-), phagocytic activity of granulocytes and monocytes were determined, the migration index, the migration inhibition index, and the exponential function were calculated. The complex of immune dysfunctions established in such patients included a decrease in the number of T-cells and, primarily, CD4+ lymphocytes and their low mitogenic reactivity, an increase in the proportion of natural killer cells, a decrease in the number of actively phagocytic neutrophils and monocytes, the last hydrogen peroxide, an increase in the production of IgA and IgG. Typical were combinations of these violations. Conclusions: T-lymphocyte-monocyte immune deficitiency with the activation of the humoral link and the defectiveness of phagocytosis is a distinctive characteristic of chronic urogenital infection.

Copyright of Studia Mythologica Slavica is the property of Scientific Research Centre of Slovenian Academy of Sciences & Arts and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Dermatophyte is a group of keratinophilic fungi that cause various skin lesions depending on the affected area. Dermatophytosis is usually diagnosed by clinical manifestation and confirmed by direct microscopy or fungal culture. There might be diagnostic difficulty with the presence of atypical dermatophytosis. Atypical dermatophytosis presents with clinical appearances ranging from eczematous, psoriasiform, pustular lesions, and others, that interferes with early diagnosis and disturbs patient’s life quality. Genital dermatophytosis is an uncommon presentation of cutaneous fungal infection; moreover, its manifestation without the involvement of the inguinal area, and simulating wart is a rare sign. In this study, we introduce a rare case of dermatophytosis with a wart-like appearance that was restricted to the skin of the genitalia. Case Presentation: A 24-years-old woman was referred to the academic dermatology clinic of Boo- Ali SINA Hospital in Sari, Iran, in November 2019 with a 9-month complaint of verrucous and pruritic plaque in the genital area that previously misdiagnosed as wart with no response to treatment. The dermatologist requested a review of the previous pathology documents for diagnosing dermatophytosis. The pathologists reexamined the relevant paraffin-embedded skin tissue block of the patient. By Periodic acid-Schiff staining, some fungal elements had been found in the horny layers of the epidermis, so dermatophytosis was confirmed. Based on this diagnosis, terbinafine was prescribed and the patient responded well to this treatment after four weeks. Conclusion: Although the occurrence of genital dermatophytosis with the verrucous appearance and without involvement of groin is a rare finding, it should be considered in the differential diagnosis. In each case suspected of genital dermatophytosis, direct examination or fungal culture for definite diagnosis and prevention of delay in the appropriate treatment is required. [ABSTRACT FROM AUTHOR]

Male genitals are highly divergent in animals with internal fertilization. Most studies attempting to explain this diversity have focused on testing the major hypotheses of genital evolution (the lock‐and‐key, pleiotropy, and sexual selection hypotheses), and quantifying the form of selection targeting male genitals has played an important role in this endeavor. However, we currently know far less about selection targeting female genitals or how male and female genitals interact during mating. Here, we use formal selection analysis to show that genital size and shape is subject to strong multivariate stabilizing sexual selection in both sexes of the red flour beetle, Tribolium castaneum. Moreover, we show significant sexual selection on the covariance between the sexes for specific aspects of genital shape suggesting that male and female genitalia also interact to determine the successful transfer of a spermatophore during mating. Our work therefore highlights the important role that both male and female genital morphologies play in determining mating success and that these effects can occur independently, as well as through their interaction. Moreover, it cautions against the overly simplistic view that the sexual selection targeting genital morphology will always be directional in form and restricted primarily to males. [ABSTRACT FROM AUTHOR]

Introduction: Some healthy males voluntarily seek castration without a recognized medical need. There are currently no standards of care for these individuals, which cause many of them to obtain surgery outside of a licensed medical setting. We seek to understand who performs these surgeries. Aim: This study aims to characterize individuals who perform or assist in genital ablations outside of the healthcare system. Methods: A cross‐sectional Internet survey posted on eunuch.org received 2,871 responses. We identified individuals who had performed or assisted in human castrations (“cutters”; n = 98) and compared this group with all other survey respondents (n = 2,773), who had not assisted in castrations. Next we compared the cutters with the voluntary eunuchs. Lastly, because many of the cutters have themselves been castrated, we also divided the physically castrated population (n = 278) into cutters (n = 44) and noncutters (n = 234) and compared them. Main Outcome Measures: Self‐reported questionnaires were used to collect demographic information, gender identity and presentation, selected childhood experiences, and history of aggressive behaviors, self‐harming behaviors, and hospitalization. Results: Distinguishing characteristics of cutters included: (i) presenting themselves as very masculine, (ii) having had their longest sexual relationship with a man, (iii) growing up on a farm, (iv) witnessing animal castrations, (v) having a history of sexually inappropriate behavior, (vi) having been threatened with genital mutilation as a child, (vii) having a history of self‐harm, (viii) being raised in a devoutly Christian household, (ix) having had an underground castration themselves, and (x) having body piercings and/or tattoos. Conclusions: This study may help identify individuals who are at risk of performing illegal castrations. That information may help healthcare providers protect individuals with extreme castration ideations from injuring themselves or others. Jackowich RA, Vale R, Vale K, Wassersug RJ, and Johnson TW. Voluntary genital ablations: Contrasting the cutters and their clients. Sex Med 2014;2:121–132.

Introduction: Female sexual arousal disorder is a pathophysiologic state characterized clinically by persistent or recurrent inability to attain or maintain an adequate lubrication-swelling response of sexual excitement until completion of sexual activity. Prior clinical experience with alprostadil products for men with erectile dysfunction supports its use in women with female sexual arousal disorder. Aim: To compare the effect of topical alprostadil with over-the-counter (OTC) lubricant on female genital arousal in the absence of visual sexual stimuli. Methods: Healthy premenopausal women without sexual dysfunction were recruited from the community to participate in the study. Of 17 women who consented, 10 were enrolled and completed the trial. The mean age of subjects was 32 years (range = 27–43). Study drug or placebo was applied topically to the genitals. Continuous temperature monitoring was performed. Participants completed questionnaires assessing genital sensation, effect, intensity, and duration. Main Outcome Measures: Change in temperature from baseline in vestibule, clitoris and vulva. Results: In all 10 subjects, topical alprostadil induced a statistically significant increase in temperature of the vestibule, clitoris, and vulva compared with the OTC lubricant. The most rapid difference in genital temperature between placebo and alprostadil was seen on the vulva, which demonstrated a significant difference at approximately 9 minutes. There was a significant difference in temperature seen for the vestibule and clitoris at 11 and 19 minutes, respectively. Sixty percent of women reported being aware or conscious of genital sensations with topical alprostadil, but not with OTC lubricant. Discordance was noted in 30% of subjects who reported being aware or conscious of genital sensations with the two treatments and 10% who reported not being aware or conscious of genital sensations with either treatment. Conclusion: Topical alprostadil administered to healthy premenopausal women induced statistically significant, sustained increases in genital temperatures of the vestibule, clitoris, and vulva within 20 minutes compared with OTC lubricant.

The objective of this study is to describe a new compression mechanism in the treatment of lymphedema of the penis and scrotum and the ensuing sexual rehabilitation. The patient, a 58-year-old man, had edema of the penile and scrotal region as a result of surgery of the pancreas and spleen and chemotherapy. The patient complained of pain, discomfort, and difficulties to walk and urinate. A clinical diagnosis of lymphedema of the penis and scrotum was reached. Treatment involved the continuous use of a cotton-polyester compression garment for the region together with thorough hygiene skin care. The swelling reduced significantly within a week to almost a normal aspect which was accompanied by clinical improvements of the symptoms. The reduction in penile edema allowed sexual rehabilitation even though erectile dysfunction required the use of a specific medication (sildenafil). In conclusion, simple and low-cost options can improve lymphedema of the penis and scrotum and allow sexual rehabilitation.

The study of molecular genetic markers (COI and ITS2), morphological characteristics and biological features of developmental stages reveals that the taxon abdominalis Gerhard, [1850] can be considered only as a subspecies of Satyrium acaciae (Fabricius, 1787).

Summary Mammalian external genitals show sexual dimorphism [ 1, 2 ] and can change size and shape upon sexual arousal. Genitals feature prominently in the oldest pieces of figural art [ 3 ] and phallic depictions of penises informed psychoanalytic thought about sexuality [ 4, 5 ]. Despite this longstanding interest, the neural representations of genitals are still poorly understood [ 6 ]. In somatosensory cortex specifically, many studies did not detect any cortical representation of genitals [ 7–9 ]. Studies in humans debate whether genitals are represented displaced below the foot of the cortical body map [ 10–12 ] or whether they are represented somatotopically [ 13–15 ]. We wondered what a high-resolution mapping of genital representations might tell us about the sexual differentiation of the mammalian brain. We identified genital responses in rat somatosensory cortex in a region previously assigned as arm/leg cortex. Genital responses were more common in males than in females. Despite such response dimorphism, we observed a stunning anatomical monomorphism of cortical penis and clitoris input maps revealed by cytochrome-oxidase-staining of cortical layer 4. Genital representations were somatotopic and bilaterally symmetric, and their relative size increased markedly during puberty. Size, shape, and erect posture give the cortical penis representation a phallic appearance pointing to a role in sexually aroused states. Cortical genital neurons showed unusual multi-body-part responses and sexually dimorphic receptive fields. Specifically, genital neurons were co-activated by distant body regions, which are touched during mounting in the respective sex. Genital maps indicate a deep homology of penis and clitoris representations in line with a fundamentally bi-sexual layout [ 16 ] of the vertebrate brain. [ABSTRACT FROM AUTHOR]

Bartsocas-Papas Syndrome (BPS) is a very rare autosomal recessive syndrome characterised by marked craniofacial deformities, multiple pterygia of various joints, limb and genital abnormalities. It is mostly associated with mutation in the gene encoding Receptor Interacting Serine/Threonine Kinase 4 (RIPK4) required for keratinocyte differentiation. The syndrome is generally lethal and majority of babies die in-utero or in the early neonatal period. This is a report about a neonate born with characteristic clinical features of BPS including severe craniofacial and ophthalmic abnormalities, limb deformities and multiple pterygia at popliteal, axillary and inguinal region. The baby had respiratory distress at birth and was managed conservatively on Continuous Positive Airway Pressure (CPAP)/Oxygen hood and injectable antibiotics for two weeks and then referred for further work-up to a tertiary hospital. The parents took the baby home against the advice of the treating doctors and she subsequently died after 10 days. BPS is associated with high mortality and so all efforts should be directed towards diagnosing it early antenatally when termination of pregnancy is a viable option. This is possible by having a high index of suspicion in couples with consanguineous marriages or with a positive family history. [ABSTRACT FROM AUTHOR]

Congenital urologic abnormalities in males may contribute to sexual dysfunction seen in young men. It is the purpose of this paper to review some of the more common congenital urologic anomalies and their impact on sexual and reproductive function.International Journal of Impotence Research (2007) 19, 115–118. doi:10.1038/sj.ijir.3901482; published online 25 May 2006 [ABSTRACT FROM AUTHOR]