Psoriasis is one of the most common a chronic inflammatory skin disease which could be associated with numerous sexual dysfunctions. According to this, the aim of this study was the analysis of sexual problems in patients with psoriasis. To be included in the review, a study had to: (i) Human data; (ii) concerned patients’ sexual problems in psoriasis; (iii) be published in an English-language journal. Studies were identified through online database searches of PUBMED, MEDLINE, Web of Knowledge (2000-2016), in all analyzed publications, researcher stressed that there was a strong relationship between psoriasis and human sexual functioning. Moreover, sexual impairment in psoriasis patients occurs in all components of the sexual response such as: sexual interest; excitation; orgasm; and erection (only in males case), as well as global sexual satisfaction. Moreover, the prevalence of sexual dysfunction was significant higher than in controls. What is interesting, the large majority of analyzed publications were focused on male patients with psoriasis. All reported publication about sexual problems in psoriasis was focused on adult patients. There were no publications in context of adolescents. The main conclusion of this paper is fact that, in dermatology, doctor needs to pay special attention to the prevention of the sexual dysfunction development in patients with skin disorders. Currently, there is no specific sexual therapy for patients with psoriasis, which would prevent the development of sexual dysfunction. This suggests the need to develop adequate interventions forms which are aimed at supporting the patients’ psychosexual development on the one hand, and prevent the development of sexual dysfunction in psoriasis on the other hand.

Outbreaks of measles in London and the South East have been reported recently despite relatively high vaccination rates. We describe the case of a 50 year old female with a delayed diagnosis of atypical measles who presented with respiratory symptoms, fever and a maculopapular eruption, who was treated for a community acquired pneumonia. Steroid and antimicrobial therapy was commenced and blood tests showed raised liver enzymes, inflammatory markers and lymphopenia. She developed a widespread maculopapular eruption which was suggestive of measles and confirmed through the presence of IgM antibodies. She was treated conservatively and made a full recovery. Our case highlights the importance of considering measles in patients presenting with a maculopapular rash and respiratory symptoms, as this can be consistent with a diagnosis of atypical measles.

The correct answer is B: phytophotodermatitis. As suggested by the term, exposure to a light-sensitizing compound from plants (a furocoumarin) and UV light is required to cause this reaction. The acute eruption can range from minimal erythema to marked red edema and vesiculation within 24 hours after initial exposure. The rash is typically nonpruritic but can be painful. As the acute rash fades, hyperpigmentation appears which can last months to years [1].

While the features of the rash are characteristic, the distribution and shape are widely variable. The well-demarcated erythema, edema, and bullae appear in bizarre patterns on sun-exposed skin consistent with the area of plant exposure. Digitate or drip-like patterns may occur from citrus or celery juice that drips during food preparation. Linear patterns may occur from brushing up against outdoor plants such as wild parsnip or hogweed. While classic cases involve obvious sun exposure outdoors, window glass does not block the ultraviolet A waves that cause the phototoxic reactions of furocoumarins [2].

Tumoral melanosis is found on histopathologic evaluation of a primary melanoma and is typically caused by regression of the tumor. The prognostic value of regression related to primary cutaneous melanoma has been controversial. Very few cases of melanosis in the sentinel lymph node have been described. We present two patients who presented with cutaneous melanoma and were found to have completely regressed metastatic melanoma present within the sentinel lymph node. One patient underwent completion lymph node dissection whereas the other opted for observation. Based on the outcomes of our two cases as well as review of other case reports of this phenomenon we discuss the biologic significance of sentinel lymph node melanosis and how it should be interpreted in relation to adjuvant therapies, staging, and follow up. Based on the unpredictable course associated with this finding we recommend that these patients be treated in a multidisciplinary fashion with treatment decisions influenced by the patient’s goals of care.

Pyogenic granuloma is a bright red benign lesion which can result in bleeding and discomfort. The aetiology is unclear, however drugs, trauma and pathogens are some causes linked to their formation. We describe a case of a 92-year-old female who presented with a rapidly growing nodule on her right second toe with no history of trauma. She had previously been prescribed the retinoid acitretin for plaque psoriasis. After excision of the first lesion the patient presented with another lesion, this time on her left heel. Her lesions resolved on cessation of acitretin therapy. Histological analysis provided a diagnosis of acitretin induced pyogenic granuloma. It is well documented that pyogenic granulomas are rare side effects in acne and psoriasis patients who take retinoid treatment. Paradoxically, retinoids inhibit the formation of vascular endothelial growth factor and would be expected to inhibit rather than stimulate the formation of pyogenic granulomas. It is possible that retinoids favour trauma or share a proangiogenic target; retinoids decrease attachments between keratinocytes and cause nail brittleness. Resolution can occur spontaneously or on cessation of the drug.