Controversies in Polycystic Ovary Syndrome

Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy that affects women from puberty to whole reproductive life. Diagnosis and treatment of PCOS is not clear. Polycystic ovary syndrome is a multisystem disease that involves dermatologist examining patients with clinical hyperandrogenism and/or biochemical signs of hyperandrogenism; gynecologist examines patients with oligo-ovulation or infertility. The management of PCOS should be tailored to each woman’s specific symptoms, fertility-related implications, and metabolic disorders. Pharmacologic treatment is not necessary for all patients with PCOS, also lifestyle changes like exercise, weight loss, and diet are effective for treatment. Lifestyle changes are often recommended as first-line treatment for PCOS to benefit general health. Topical nonhormonal therapies and laser hair removal may be effective for cutaneous symptoms like acne, hirsutism, and androgenetic alopecia in the PCOS population and are useful first-line agents. Some pharmacological agents (anti-androgens) are used to control the dermatological symptoms of hyperandrogenism. Metformin is useful for metabolic and glycemic anomalies and for the treatment of menstrual irregularities, but less effective than antiandrogens for the treatment of both hirsutism and acne. The aim of this study is to talk about unclear topics in PCOS and multidisciplinary approach to patients

Successful treatment of generalised discoid lupus erythematosus with imiquimod cream 5%: A case report and review of the literature

Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus and tends to heal with scarring, hair loss and pigmentary changes if treatment is not initiated in the early phase of the disease. Classic DLE lesions are initially red-purple macules, papules or small plaques that rapidly acquire a hyperkeratotic appearance. Only a minority of the patients with DLE progress to develop systemic lupus erythematosus (SLE). A small percentage of patients with SLE have concomitant DLE. However, generalised DLE is more frequently associated with systemic involvement than classic DLE. The diagnosis of DLE is usually based on clinical features, although in some cases histopathologic examination may be required to confirm the diagnosis. Standard therapy for cutaneous lupus includes broad-spectrum sunscreens, topical and intralesional glucocorticoids and antimalarial agents. A 63-year-old man presented with erythematous scaly patches that he had had on his face for approximately eight months. Although it was mainly his face that was affected, lesions were also noted on his scalp, neck, chest, shoulder, upper arms and trunk. Histopathologic examination verified the diagnosis of DLE. No systemic involvement was detected through laboratory examinations or consultations with the other departments. Imiquimod cream 5% was applied three times a week, every other week. After 24 applications over a period of two months an almost complete improvement was achieved. Topical imiquimod may, then, be an alternative treatment for generalised DLE

Nicolau syndrome following intramuscular injection of oxytocin in pregnant women: report of two cases

Nicolau syndrome, also known as embolia cutis medicamentosa, is a well known but very rare complication occuring after intramuscular drug injections and presenting with local intense pain. Immediately after injection the skin blanches and within minutes to hours an erythematous macule develops, which evolves into a livedoid violaceous patch with dendrites. This condition is initially hemorrhagic, then it ulcerates, and eventually heals with an atrophic scar. Many different drugs have been reported to cause Nicolau syndrome . To date there have been no reports of Nicolau syndrome caused by intramuscular oxytocin injection. We would like to report two cases that occured after intramuscular injection of oxytocin

Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas

Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva

Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas

Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva