IntroductionInverse psoriasis is a rare form of psoriasis that affects between 3% and 7% of the patients with psoriasis. It can comprise genital skin folds as part of genital psoriasis, and it is one of the most commonly seen dermatoses of this area. There are few evidence-based studies about the treatment of intertriginous psoriasis involving genital skin folds.Case PresentationThe authors present a 42-year-old female patient with erythematous plaques in the vulva, groin, and perianal region. The patient had previously received a broad range of topical and systemic therapies that had to be discontinued due to ineffectiveness or side effects. She was treated with 100 mg dapsone daily for 10 months, showing a significant improvement of her cutaneous and mucous lesions. Complete clearance of psoriatic lesions was observed after 4 weeks of treatment. She has remained in remission for up to 2 years, using only topical therapy with tacrolimus 0.1% and calcipotriol.DiscussionGenital psoriasis is a skin disease that causes great discomfort. It is important to include examination of the genital region and to adopt this conduct in daily clinical practice. Research in this field is still poor, making no discrimination between flexural and genital psoriasis, and is based on case series and expert opinion; therefore, empirical recommendations for the treatment of genital psoriasis remain. Dapsone has been shown to be an effective and convenient alternative for the treatment of inverse psoriasis in genital skin folds, which can provide effective control of the disease. Further studies are required to determine the efficacy and safety of current therapies, and to decide whether dapsone therapy should be considered in the management of this form of psoriasis when topical and other systemic agents are not effective.

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Background Psoriasis is a chronic inflammatory skin disease associated with several important medical comorbidities. There are scant data available on the comorbidities of patients with psoriasis in South America. Aim To examine the comorbidity profile of adult patients with psoriasis in Chile and its association with severity of psoriasis. Methods This was a multicentre, cross‐sectional study involving 16 hospitals and clinics in Chile, which used a 48‐item questionnaire to study clinician‐ and patient‐reported outcomes and comorbidities. Inferential analyses were performed by psoriasis severity, using Fisher exact test, Student t‐test and multivariable logistic regression. Results In total, 598 adult patients with psoriasis were included (51.1% male; mean age 49.2 ± 15.1 years); 48.5% mild and 51.4% moderate to severe; Psoriasis Area and Severity Index 11.6 ± 11.5; body surface area 14.7 ± 18.2%. Plaque psoriasis was the most common phenotype (90.2%), followed by guttate (13.4%). Psoriatic arthritis occurred in 27.3% of patients. Comorbidities were reported in 60.2% of all patients with psoriasis. Frequent concomitant diseases were obesity (25.3%), hypertension (24.3%), Type 2 diabetes mellitus (T2DM) (18.7%), dyslipidaemia (17.4%), metabolic syndrome (16.7%) and depression (14.4%). After adjustment, significant associations were found between moderate to severe psoriasis and obesity, T2DM and nonalcoholic fatty liver disease (NAFLD) compared with mild psoriasis. Conclusions We report a large study of comorbidities, including depression, dyslipidaemia, T2DM and NAFLD, in people with psoriasis in Chile. The prevalence of comorbidities with psoriasis in Chile appears similar to that found in Western countries, and emphasizes the importance of assessing patients with psoriasis for risk factors for and presence of, comorbid disease in a multidisciplinary setting.

Alopecic and aseptic nodules of the scalp, also named pseudocysts of the scalp, are a relatively new, little-known, and for sure underdiagnosed disease. It affects mostly young men and is characterized by a solitary or a few dome-shaped nodules accompanied by nonscarring alopecia, deep inflammatory infiltration in the skin biopsy specimen, and, in most cases, granulomas. It has a good response to doxycycline, intralesional corticosteroids, or drainage/aspiration of the lesion. We present a case report and a summary of the published cases.

Due to the Coronavirus-19 (COVID-19) pandemic, most resources of the public health system were allocated to the increasing demand from respiratory patients. From this, it is expected that specialty consultations would decrease drastically. Access to dermatology care in the Chilean public health has been historically limited. To evaluate the impact of the pandemic on dermatology care, the total number of dermatological consultations (DCs) to the Chilean public sector in 2020 is analyzed according to sex and age range and compared with the available databases from 2017 to 2019. From this, 120,095 DCs were performed during 2020, with an incidence of 6.3 consultations per 1000 inhabitants. When compared to 2019 (n = 250,649), there was a 52.1% decrease. The regions most affected were located in the central part of Chile, which correlates with the regions most affected by the pandemic. Age and sex distributions remained similar to previous years but lower in amplitude. The month with the lowest number of consultations was April, with a gradual increase observed thereafter until December 2020. Although DCs decreased drastically in the Chilean public sector during 2020, sex and age range proportions were conserved, thus affecting all groups in a similar manner.

IntroductionCutaneous tuberculosis (TBC) is a chronic disease caused by Mycobacterium tuberculosis, and is present in less than 1–2% of all TBC cases. The current problem with diagnosis is the demonstration of bacillus in the skin, especially paucibacillar forms, where sources like polymerase chain reaction (PCR) have improved diagnostic capacity.Case PresentationTwo cases of cutaneous TBC are reported. The first patient was 52-year-old woman with facial erythematous papulo-nodular lesions which had been developing for 4 months, and had previously been treated as acne rosacea, with partial response. Histopathological studies showed chronic granulomatous inflammation. TBC was suspected, so PCR was performed, which showed positive for M. tuberculosis. The second case was a 43-year-old woman with a facial rosaceiform plaque which began 6 months previously, and was treated as rosacea without any change for 5 months. Skin biopsy and PCR were positive for TBC. Both cases were treated using primary schedule for TBC, and both presented a favorable response.DiscussionA clinical profile called Lewandowsky’s rosacea-like eruption has been previously described. The condition has been questioned for years and was later removed from the spectrum of tuberculids and cutaneous TBC for not being able to isolate microorganisms in skin samples, a situation that might now change. In paucibacillar forms, when culture and staining are negative and TBC is still suspected, it is recommended to use DNA amplification by PCR for an accurate diagnosis. Both cases bring up the concern about once again bringing Lewandowsky’s rosaceiform eruption into the spectrum of cutaneous TBC, and the discussion about the current definition of tuberculid.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-014-0066-x) contains supplementary material, which is available to authorized users.

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Several treatments have been described for cutaneous loxoscelism (CL), but the quality of available evidence is insufficient for the elaboration of a therapeutic consensus. Dapsone has shown beneficial effects on stopping the inflammatory phenomenon and accelerating the recovery. It is recommended to start dapsone once the visceral involvement is ruled out if glucose‐6‐phosphate dehydrogenase levels are normal. Autologous fibroblast (AF) therapy is a novel therapy that has been successfully used in bioengineering as skin substitutes for surgical wounds and burns, diabetic and pressure ulcers, and other aesthetic purposes. Interestingly, there are no reports of AFs in CL. We present a case of CL in which the necrotic process was stabilised with dapsone, but the healing of the ulcer was not achieved. Three weekly applications of AFs 100 000/cm2 were performed on a biocompatible polymer matrix, with optimal response within 2 months. This represents the first report of AFs in CL, setting the stage for future studies.