Lymphangioma circumscriptum of glans penis: a report of two cases.

Lymphangioma circumscriptum is a developmental anomaly of lymphatic vessels, which appear as aggregates of clear or hemorrhagic vesicles on the skin or mouth. Glans penis involvement is very uncommon. Because of the sensitivity of the area, possible functional, cosmetic, or psychologic disturbances can result. Lymphangioma circumscriptum is rarely found on this location; hence, vigilance and awareness of this entity is necessary for a swift and proper diagnosis. Two cases are presented on the account of their rarity and unique representation.

The efficacy of methotrexate plus pioglitazone vs. methotrexate alone in the management of patients with plaque-type psoriasis: a single-blinded randomized controlled trial.

Recently, thiazolidinediones have shown to be efficacious with a favorable safety profile when used in the treatment of chronic plaque-type psoriasis. The aim of this study was to evaluate and compare the efficacy and safety of a combination of methotrexate plus pioglitazone and methotrexate alone in plaque-type psoriasis. A total of 44 adult patients with plaque-type psoriasis were included in the study. Patients were randomized to treatment with methotrexate alone (group A) or methotrexate plus pioglitazone (group B) for 16 weeks. The primary efficacy outcome measure was psoriasis area and severity index (PASI) score change between the study groups at week 16 relative to baseline. The secondary efficacy outcome measure was dermatology life quality index (DLQI) score change between the two groups at week 16 relative to baseline. The PASI 75 score was also measured. After 16 weeks of therapy, the percentage of reduction in the mean PASI score was 70.3% in group B and 60.2% in group A. PASI 75 was achieved in 14 patients (63.6%) in group B compared with two patients (9.1%) in group A within 16 weeks, which was significant (P < 0.001). At 16 weeks from the baseline, a 63.6% decrease in the mean DLQI score of group B was seen, while the decrease for group A was 56.9%. Pioglitazone enhances the therapeutic effect of methotrexate in plaque-type psoriasis, as demonstrated by a reduction in the mean PASI scores. In terms of DLQI, there was no extra benefit by the addition of pioglitazone to methotrexate therapy.

Indeterminate cell histiocytosis: report of a case.

Indeterminate cell histiocytosis is a very rare disorder of histiocytes proliferation. It has both Langerhans and non-Langerhans cell histiocytosis immunophenotypic features. We described a 45-year-old man with a 2 years history of multiple yellow-brown papules and a few red nodules on his trunk and extremities. No internal involvement was detected first and after 8 months. As his lesions were asymptomatic and sparse, he didn't receive any treatment. He will be followed at regular intervals.

Combination therapy of infantile hemangioma with pulsed dye laser with topical propranolol: a randomized clinical trial.

BACKGROUND: The combination of pulsed dye laser (PDL) and topical propranolol are used with variable effectiveness for the treatment of infantile hemangiomas (IH), particularly for superficial lesions. OBJECTIVE(S): The aim of this study was to investigate whether the therapeutic efficacy of prescribing topical propranolol along with PDL was superior to PDL therapy alone in the treatment of IH. METHODS: A total of 19 patients with IH were recruited to the study. Among them, nine patients were treated with PDL, 3 sessions 4 weeks apart, and 10 patients underwent PDL treatment alongside with topical propranolol for 12 weeks. The therapeutic efficacies of each regimen were assessed by comparing photographs of skin lesions before and after the treatment based on the cessation of the lesion growth, reduction in the lesion size, and lightening of the lesion color. RESULTS: No side-effect was reported by the parents. Among nine patients in PDL group, only two (22%) had excellent clearance, one (11%) had good, three (30%) had weak, and three (30%) had no responses. On the other hand, among 10 patients who were treated with both the PDL and topical propranolol, five (50%) showed excellent responses and five (50%) displayed good responses. Statistical data analysis with Mann-Whitney test revealed a significant difference in the clinical response between two treatment groups. CONCLUSION: The combination of PDL and topical propranolol seem to be a safe and effective therapy, and results in better clinical responses in the treatment of IH than PDL therapy alone.