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The relationship between the incidence of bovine teat papillomatosis and the activity of haematophagous flies was investigated in Japan. A total of 15,737 flies consisting of 33 species were collected by dry ice‐baited mosquito net (DMN) trap and a sweep net from udders of cattle. Simulium aokii (Takahasi) of Simuliidae (black flies) was the predominant species, followed by S. tobetsuense Ono and S. iwatense (Shiraki). Simulium aokii had the highest peak in October, followed by September. Numbers of blood spots from the bites per teat in nulliparous cattle were significantly correlated with numbers of S. aokii collected by DMN trap. Numbers of teats with warts and spots of blood from the bites per teat were significantly more abundant in anterior teats than posterior teats. The average incidence of teat papillomatosis in nulliparous cattle was significantly higher than that in parous cattle, and the highest incidence by month was in May, followed by April. Although bovine papillomavirus (BPV) DNA was not detected in flies examined, the presence of black flies and blood spots from their bites were associated with subsequent high incidence of growing warts. In particular, it would pay to give attention to species such as S. aokii that severely attack udders in the present locality. Further investigations for the detection of BPV DNA from flies parasitizing on teats are needed. [ABSTRACT FROM AUTHOR]

A plantar wart is a benign hyperplasia that appears on the feet due to the human papillomavirus (HPV). One method used for the treatment of recalcitrant plantar warts, those lasting over 2 years or persisting after at least two treatment attempts, is the cantharidin (1%), podophyllin (5%), and salicylic acid (30%) formulation, also known as the CPS formulation. Although this method is in use, there are few studies on it. This study's objective was to ascertain its cure rate. For this retrospective observational study, we reviewed the medical records of patients treated with the CPS formulation at a podiatric clinic specializing in plantar wart treatment. Our sample size was 48 subjects. The CPS formulation had a cure rate of 62.5%. Out of the cured patients, 86.67% (26/30) required one or two applications. There was no observable correlation (p > 0.05) between wart resolution and virus biotype, evolution time, patient's morphological and clinical attributes, location, number of warts, or preceding treatments. The CPS formulation presents a relatively high efficacy rate for treating recalcitrant HPV plantar warts. Still, additional studies are necessary to evaluate its safety and efficiency. [ABSTRACT FROM AUTHOR]

This article discusses the use of dupilumab, a biologic medication, for the treatment of atopic dermatitis (AD) in pediatric and young adult patients with inborn errors of immunity (IEIs). The medication has been approved for use in children with moderate to severe AD who have inadequate control with topical therapies. The article presents case studies of patients with IEIs and AD who were treated with dupilumab, showing significant clinical improvement as early as week 4 of treatment. However, further studies are needed to evaluate the long-term safety and efficacy of dupilumab in this patient population. [Extracted from the article]

Background: The clinical strategy of oral supplementation of Vitamin D (VD) as a preventive and therapeutic measure for warts needs further exploration. Methods: The clinical data of patients with skin diseases who visited the Children's Hospital affiliated with Chongqing Medical University from February 2018 to June 2024 were collected. The serum VD levels in patients with warts (common warts, flat warts, and plantar warts) and patients with other common skin diseases (atopic dermatitis, psoriasis, alopecia areata, vitiligo, and chronic urticaria) were compared. Two‐sample bidirectional Mendelian randomization (MR) analysis was performed to investigate potential causal associations between VD and warts. Results: The average serum VD level of children with warts was 23.27 ± 7.07 ng/mL, which showed no statistically significant difference compared to children with other common skin diseases. The inverse variance weighted (IVW) method analysis indicated a positive causal relationship between VD and warts (Odds Ratio [OR] = 1.86, [95% CI: 1.19−2.92], p = 0.007). Sensitivity analysis did not show any indication of horizontal pleiotropy or heterogeneity. The MR‐PRESSO method did not identify any outliers. Conclusion: The levels of serum VD in children with warts do not significantly decrease compared to children with other common skin conditions. The evidence from the MR analysis indicates a positive causal relationship between VD and warts, suggesting caution in supplementing VD for children with warts who have normal or elevated serum VD levels. Further clinical studies are needed for validation in the future. [ABSTRACT FROM AUTHOR]

This article discusses the use of vitamin D as a potential treatment for warts. Warts are difficult to treat, and current treatment options are not always effective. Vitamin D has been shown to have immune therapeutic properties and can inhibit keratinocyte proliferation, which is a therapeutic goal in managing warts. Studies have demonstrated the beneficial effects of intralesional and topical vitamin D in treating resistant warts. However, the efficacy of vitamin D treatment can vary depending on the specific subtype of HPV involved and other factors such as dose and duration of treatment. Further research is needed to fully understand the potential of vitamin D in wart management. [Extracted from the article]

The article discusses the diagnostic challenges of Atypical Spitz Tumor (AST), a rare melanocytic lesion that can be mistaken for spitzoid melanoma. The use of Line-field confocal optical coherence tomography (LC-OCT) is introduced as a non-invasive technique to aid in distinguishing AST from benign Spitz nevus, particularly in pediatric patients. LC-OCT provides 3D reconstructions of the skin at cellular resolution, highlighting architectural disorder and cytological atypia within melanocytic nests. Further studies are needed to differentiate AST from other entities, and patient consent was obtained for the publication of case details. [Extracted from the article]

This article presents the findings of a study on the association between hyperhidrosis and skin infections in adults from diverse racial and ethnic groups. The study found that both generalized and focal hyperhidrosis were linked to an increased risk of various skin infections compared to controls. The risk of skin infections varied among different racial and ethnic groups. The study supports the idea that persistent moisture and skin breakdown contribute to skin infections in individuals with hyperhidrosis. Effective management of hyperhidrosis is important in reducing the risk of secondary skin infections. [Extracted from the article]

Background: Verrucas that occur on the soles of the feet are called plantar warts, most of which can recur repeatedly and are difficult to eradicate. Hypertrophic and refractory plantar warts are often accompanied by pain and discomfort, which cause many inconveniences in patients' daily lives. Aim: This study aimed to analyze the therapeutic effect of superficial radiotherapy (SRT‐100) on refractory plantar warts and further create favorable conditions for the subsequent treatment of this disease with a high recurrence rate. Methods: A retrospective analysis was conducted for refractory plantar warts treated with superficial radiotherapy in our outpatient department from January to June 2023. Results: A total of 30 patients were included in our study (median age, 33 years). The female‐to‐male ratio was 1:3.29. Two to six months after radiotherapy, all of the warts subsided in 23 (76.67%) patients, most of the warts subsided in 4 (13.33%) patients, 3 (10%) patients did not respond to treatment, and 7 (23.33%) patients had recurrent or new warts after their warts subsided. Conclusions: Most patients with refractory plantar warts improved after superficial radiotherapy. Our study presented that men are more susceptible to plantar warts than women, and young and middle‐aged people are the main population affected by the disease. Superficial radiotherapy is an effective treatment for refractory plantar warts, which can quickly remove the warts in a short period. It is safe and noninvasive, with minimal adverse reactions. Some patients relapse after the lesion is clear, and superficial radiotherapy can create favorable conditions for the subsequent treatment of viral warts in clinical practice. [ABSTRACT FROM AUTHOR]

Seven of 60 Perendale sheep within a flock developed single or multiple exophytic masses on their distal hind limbs. A mass was excised from one sheep and histological evaluation revealed epidermal and mesenchymal proliferation, papillomavirus‐induced keratinocyte changes and marked keratohyalin clumping. Ovis aries papillomavirus type 2 DNA sequences were amplified using PCR. [ABSTRACT FROM AUTHOR]

Background: Verrucae are benign proliferations caused by human papillomavirus. Treatment is needed for pain, bleeding, contagiousness, and cosmetically. Aims: The aim of this study is to evaluate the effectiveness of KTP laser treatment in verrucae, as well as side effects and recurrence rates. Patients and Methods: Patients who had Verrucae vulgaris (V. vulgaris) and Verrucae plantaris (V. plantaris) previously treated with KTP laser were scanned for their eligibility. Twenty‐nine patients who met the inclusion criteria were included. There was complete recovery in 24 patients (82.8%) and partial recovery in two patients (6.9%). Three patients (10.3%) were unresponsive to treatment after six sessions (no recovery). Two patients had mild pain during the application, and 65.4% of the patients had complete cosmetic recovery at the 3rd month follow‐up. Results: As a result, we found that the standard KTP laser can be an effective option for both types of verrucae. Conclusions: We think KTP laser treatment can be preferred for verrucae treatment. [ABSTRACT FROM AUTHOR]

Imiquimod, a medication used to treat dermatological conditions, has been found to induce psoriasis or psoriasis-like lesions in some patients. This systematic review examines the literature on this adverse drug reaction, known as IMQ-p, in humans. The review includes 11 cases from case reports and case series, with patients ranging in age from 5 to 89. The most common type of psoriasis developed was plaque psoriasis, mainly on the scalp and extremities. Topical corticosteroids were the most common treatment used for IMQ-p. However, the literature on this topic is limited, and further research is needed to guide clinical decision-making. [Extracted from the article]

Background: Plantar warts are common infectious cutaneous growths causing severe physiological and psychological discomforts in patients and heaving global financial burdens. However, paucity of clear‐cut guidelines for plantar warts, selecting appropriate treatments for plantar warts remains challenging. The objective of the study is to evaluate the efficacy and safety of common treatments for plantar warts. Methods: PubMed, EMbase, and The Cochrane Library were searched from inception to March 1, 2023 for randomized controlled trials (RCTs) of plantar warts. The primary outcome (complete response) and secondary outcome (recurrence and pain) were extracted and combined using Bayesian network meta‐analysis (NMA) with random‐effect and fixed‐effect models. Results: Totally, 33 RCTs were included in the systematic review and quantitative NMA. In NMA of complete response, topical application of 1% cantharidin, 20% podophylotoxin, 30% salicylic acid (CPS), microneedles plus bleomycin (MNB), and intralesional bleomycin injection (INB) were the only three treatments significantly superior to no treatment (NT) and CPS was of the highest possibility to be the top‐ranked treatment (SUCRA = 0.9363). However, traditional warts treatments, salicylic acid (SA) and cryotherapy were not superior to NT. Conclusions: The NMA has produced evidence for using CPS, MNB, and INB, which are all topical antimitotic treatments, to improve the management of plantar warts. The classic treatment modalities for plantar warts, including SA and cryotherapy, may play a less important role in the clinical practice of plantar warts. [ABSTRACT FROM AUTHOR]

Cutaneous warts are an exceedingly common cutaneous viral infection for which existing treatment options are often painful, expensive, and only marginally effective. Extensive warts may occur in the setting of primary immunodeficiencies, wherein they can co‐occur with other diseases of immune dysfunction, such as atopic dermatitis (AD). Dupilumab, an IL‐4 receptor α (IL‐4Rα)‐blocking monoclonal antibody, is a biologic agent recently approved for the treatment of moderate‐to‐severe eczema. Here, we report a case of a young girl with both severe AD and diffuse filiform warts, which resolved shortly after initiating treatment for AD with dupilumab. [ABSTRACT FROM AUTHOR]

Objective: Multiple palmoplantar warts, caused by human papillomavirus (HPV) infection, were investigated for clinical efficacy using cantharidin, retinoic acid cream, and salicylic acid cream. Methods: A total of 110 patients with multiple palmoplantar warts were enrolled. The experimental group (54 cases) received a 1:1:1 combination (CRS) of 0.25% cantharidin, 0.1% retinoic acid cream, and 5% salicylic acid, applied with pressurized encapsulation for 8 h every night, three times per week. The control group (56 cases) underwent conventional liquid nitrogen freezing. Monthly follow‐ups assessed cure rate, effective rate, dermatological life quality index (DLQI), visual analog scale (VAS), and cost, with evaluations conducted after 3 months. Results: The treatment group exhibited a cure rate of 85.19% and a total effective rate of 96.30%, surpassing the control group with rates of 39.29% and 51.79%, respectively (p < 0.05). The treatment group's DLQI score (1.84 ± 1.06) was significantly lower than the control group's score (6.04 ± 1.78) (p = 0.0005). Additionally, the treatment group's VAS score (1.84 ± 1.06) was notably lower than the control group's score (8.56 ± 1.07) (p < 0.0001). The treatment group's total cost (43.20 ± 2.85) was markedly lower than the control group's cost (206.38 ± 90.81), with a statistically significant difference (p < 0.0001). Conclusion: The combination of cantharidin, retinoic acid cream, and salicylic acid with local encapsulation is a safe, effective, economical, and convenient treatment method for multiple palmoplantar warts, exhibiting few side effects and showing promise. [ABSTRACT FROM AUTHOR]

Background: Individuals with pre‐existing chronic kidney disease (CKD) are at an increased risk of experiencing severe symptoms if infected with COVID‐19. This report presents the case of a patient with CKD who contracted COVID‐19 and subsequently experienced rapid deterioration of kidney function, hair loss, and spontaneous remission of facial warts. Case presentation: A 60‐year‐old Chinese man with a decade‐long history of abnormal serum creatinine (Scr) levels and recently heightened fatigue sought treatment. The disease was previously managed and deemed resolved in 2020. However, when he contracted the novel coronavirus on December 20, 2022, he experienced persistent fatigue without other symptoms. In early January 2023, Scr levels was examined as more than 300 μmol/L. This was followed by hair loss, including eyebrows and lashes, and the spontaneous resolution of a longstanding facial wart. During this period, although the patient received kidney‐protecting drugs and a lifestyle optimization, Scr increased continuously and the disease eventually progressed to the uremic stage. As the patient still had relatively abundant urine volume, the patient chose peritoneal dialysis treatment. At a two‐month follow‐up, he had adhered to the CAPD protocol without complications and his hair had begun to regrow. After eight months, his hair had mostly regrown, and his Scr levels kept stable. Conclusion: This case may represent the inaugural instance of CKD patients experiencing rapid deterioration of renal function, hair loss, and spontaneous remission of common warts. The underlying mechanisms of this unique phenomenon warrant further researches and debate. [ABSTRACT FROM AUTHOR]

A 42-year-old man visited a dermatology clinic with multiple brownish papules arising from a red ink tattoo on his right arm. Dermoscopy revealed a red pigment background, perifollicular hypopigmentation, and linear vessels. A punch biopsy confirmed the presence of a plexiform variant Spitz nevus, characterized by microaggregates of spindle melanocytes arranged in bundles and globules. The patient underwent excision of the red band, revealing similar findings in the other papules. The article highlights the challenge of identifying skin lesions within tattoos and discusses the uncertain link between tattooing and the development of malignant tumors. It emphasizes the importance of considering Spitz nevus in the evaluation of papular tattoo reactions. [Extracted from the article]

Background: Viral warts are common infectious skin disease induced by human papillomavirus (HPV). Lasers have been used for warts treatment in recent years with variable success rates. Objective: This study aimed to prospectively evaluate combined treatment with Er:YAG laser and long‐pulsed Nd:YAG laser compared to Er:YAG laser for the treatment of recalcitrant warts after one session. Materials and Methods: This study included 240 lesions from 24 patients. All the lesions were diagnosed clinically as recalcitrant warts after failure of topical treatment and cryotherapy. About 120 lesions underwent a combined therapy of Er:YAG and long‐pulsed (LP) Nd:YAG lasers, and the remaining 120 lesions underwent Er:YAG laser therapy only. The clearance rate was evaluated 5 weeks after and classified by three‐graded evaluation: complete response, partial response and poor response. Results: The clearance rate in the combined Er:YAG + LP Nd:YAG lasers group was, statistically significant, higher than that of the Er:YAG laser group (p = 0.008). The complete response rate was 48% (58 of 120 warts) for the Er:YAG +LP Nd:YAG lasers group and only 29% (35 of 120 warts) for the Er:YAG laser group. Conclusion: The combination of Er:YAG and long‐pulsed Nd:YAG lasers is more effective than Er:YAG laser alone in treating recalcitrant warts after single session. [ABSTRACT FROM AUTHOR]

Cryotherapy is commonly regarded as the primary treatment method for plantar warts. A new medical device called nitric–zinc complex solution (NZCS) has also emerged as a potential alternative for wart treatment. The main aim of this study was to analyze and compare the effectiveness of cryotherapy using liquid nitrogen and NZCS in treating plantar warts. We conducted a randomized and controlled clinical trial involving patients with plantar warts. A total of 62 patients were enrolled in the study and monitored for 12 weeks or until their warts were completely resolved. The patients received either cryotherapy or NZCS, with a maximum of six treatment applications. The cure rate was 65.5% in the group treated with cryotherapy and 56.6% in the group treated with NZCS. The average number of treatment applications required for curing warts was significantly lower in the cured group (3.28 ± 1.63) than in the group with unresolved warts (5.5 ± 1.27) (p < 0.01). Moreover, the average number of applications was lower in the cryotherapy group (3.6 ± 1.8) than in the NZCS group (4.8 ± 1.8) (p < 0.01). Based on the findings, NZCS could be considered a favorable first‐line treatment option for plantar warts. [ABSTRACT FROM AUTHOR]

Background: Plantar warts (verrucae plantaris) are a common source of pain for patients and are often refractory to treatment. Previous work has shown a high clearance rate of verrucae using a surface‐based microwave device (Swift®). Aims: To assess the efficacy, defined as the complete visible clearance of warts, in patients with verrucae plantaris receiving microwave treatment. Patients: We undertook a retrospective review and identified records of 85 patients who underwent a course of microwave treatment at a single US‐based podiatry centre. Efficacy was analyzed on the basis on intention‐to‐treat. Results: In patients who received ≥1 session there was a complete clearance rate of 60.0% (51/85) (intention‐to‐treat; 59 patients completed treatment, 26 lost to follow‐up) and 86.4% (51/59) per treatment completion; no significant differences in clearance rates of children and adults were observed (61.0% [25/41] vs. 59.1% [26/44]). There were 31 patients who received three sessions of microwave therapy with a clearance rate of 71.0% (22/31) as per intention‐to‐treat (27 patients completed treatment, 4 lost to follow‐up). An average of 2.3 sessions (SD: 1.1; range: 1–6) was required for the complete clearance of plantar warts. Complete clearance was also observed in some patients with recalcitrant warts following additional treatment sessions (42.9% [3/7]). A significant reduction in wart related pain was reported for all patients undergoing treatment. Some patients continued to report a reduced amount of pain post‐therapy compared with pretherapy. Conclusions: Microwave treatment of verrucae plantaris appears to be a safe and effective procedure. [ABSTRACT FROM AUTHOR]

The letter to the editor discusses the use of topical cidofovir as a treatment option for squamous papillomas, specifically those in the anterior vestibule of the nasal cavity. The authors present a case study of a patient with a recurrent nasal squamous papilloma that was successfully treated with topical cidofovir. They highlight that this treatment option is convenient, safe, and painless for the patient, and avoids the need for repeated surgical procedures. However, the main limitation is the cost of the treatment. The authors recommend considering topical cidofovir as an adjunctive treatment option for squamous papillomas. [Extracted from the article]

Background: Few studies have addressed the relationship of human papillomavirus (HPV) biotypes to patient characteristics and the clinical signs, course, and response to the treatment of plantar warts. Objective: Analyze the HPV types associated with plantar warts and their relationship with warts characteristics, patient characteristics and response to treatment. Methods: A total of 372 patients sampled for hyperkeratosis of a plantar wart were included. Multiplex polymerase chain reaction (PCR) was performed to detect the HPV biotype. Results: The prevalence of HPV was 81.2%, and HPV1 was the most prevalent biotype (36.1%). HPV1 was the most prevalent biotype in patients < 70 years old (90.9% in < 10 years), and biotypes 2, 19 and 27 were the most prevalent in patients > 70 years old (p = 0.012). HPV1 was the most frequent in patients with one (39,9%) or two (47.1%) warts and HPV5 (33.3%) in patients with three warts (p < 0.001). Cure, spontaneous resolution, and recurrence were higher in HPV1 (p < 0.001). HPV14 warts healed the fastest (2 months quartile 1–3 (2.0–2.0)), and HPV5 (10.977 (6.0–20.0)) and HPV27 (7.5 (3.0–10.0)) warts (p = 0.033) took the longest to heal. Conclusions: HPV biotype is associated with age and the number of warts and appears to influence the natural history of warts and their response to treatment. [ABSTRACT FROM AUTHOR]

Background: Pediatric oncology patients undergoing cancer treatment can often have numerous and recalcitrant cutaneous warts due to their underlying immunosuppression. There are little published data on the optimal management of warts in pediatric oncology patients undergoing active cancer treatment compared to patients having completed treatment. Our objective was to analyze the clinical course of warts treated within this patient population at Boston Children's Hospital over a 10‐year period. Methods: This was a single‐institution retrospective study of 72 pediatric oncology patients from 1 September 2011 to 1 September 2021 who were treated for warts at Boston Children's Hospital. All patients had a diagnosis of cutaneous warts with at least one follow‐up visit and were receiving active treatment for cancer either during or after concurrent treatment of their warts. We examined the modality and effectiveness of wart treatments while both on and offactive treatment of their cancer. Results: The median age was 12 years (range 4–18). Fifty‐four percent of patients were documented to have plantar warts. Sixty percent of patients with a documented number of warts had more than five warts at presentation. For cases in which outcomes were specified, treatment resulted in complete resolution of warts in only 24.0% of patients undergoing active cancer treatment compared to 63.3% of patients not on active treatment. Warts persisted or worsened in 56.0% of patients undergoing active cancer treatment compared to only 13.4% of patients not on active treatment. Conclusion: These data may help guide clinicians in evaluating and treating warts in pediatric oncology patients. [ABSTRACT FROM AUTHOR]

Infantile perianal pyramidal protrusion (IPPP) is a benign condition generally noted in childhood but may persist for several years. Dermoscopy may help to distinguish it from other conditions, particularly genital warts. We report six cases of IPPP and describe the dermoscopic features that will distinguish these lesions from verrucae. [ABSTRACT FROM AUTHOR]

Background: Viral warts, induced by infection by different HPV genotypes, are highly frequent in the general population, particularly during infancy and among adolescents. The effectiveness of the 595 nm Pulse dye‐laser in treating viral warts on the hands and feet in both adults and children was investigated in this study. Materials and Methods: A selection of 203 patients with multiple viral warts was made. All patients underwent 4–5 treatment sessions with a 595 nm pulse Dye Laser (PDL). Treatment outcome was assessed by a quartile scale: 1 indicates no or low results (0%–25% of the lesion area cleared), 2 indicates slight clearance (25%–50% of the lesion area cleared), 3 indicates moderate‐good clearance (50%–75%), and 4 indicates excellent clearance (75%–100%). Patients were asked for a subjective evaluation of the perceived overall results by means of the following score: unsatisfied (1), not very satisfied (2), satisfied (3), and very satisfied (4). Possible side effects were monitored. Results obtained were judged with a photographic evaluation, immediately and at the control visit (6 months after the last laser session). Results: All patients observed global improvements. Most of the lesions were completely removed after laser therapy. A total of 95% of patients achieved excellent clearance and they were very satisfied following the laser treatment. Relevant side effects were absent in all patients. Conclusion: PDL treatment with the study device using a wavelength of 595 nm has proven to be a tolerable and safe therapy for viral warts management. [ABSTRACT FROM AUTHOR]

Background: Warts are one of the contagious viral diseases that may cause disturbing cosmetic problems. Plane warts represents a common self‐limiting viral infection of the skin caused by the Human Papilloma Virus, however, those that do not disappear by themselves can be very difficult to treat with no uniformly effective treatment modality. Objective: To assess the efficacy of long pulsed 532 nm ND:YAG laser in the treatment of plane warts. Patients and Methods: In this therapeutic clinical trial study, 34 patients with plane warts were enrolled. Each patient was eligible for up to three treatment sessions administrated at 2 weeks intervals with long pulsed ND:YAG laser at a spot size 3 mm; wavelength 532 nm; pulsed duration 20 ms; and fluence 30 J/cm2. The patients were assessed before each treatment session and at 3 months after the last treatment session. The response to treatment was graded using four points scale: Scale 1 = poor: <25%, Scale 2 = fair: 25%–50%, Scale 3 = good: 51%–75%, Scale 4 = excellent: >75%. Results: Twenty‐two patients only with a total of 478 lesions, completed the study; their ages ranged from (6–45) years with a mean ± SD 19.95 ± 13.142 years. Thirteen patients (59.09%) were female and nine (40.90%) were male. The results from this study showing that long pulsed ND:YAG laser 532 nm led to an excellent response in 19 patients (86.36%) in which 15 of 19 patients showed a complete response (78.94%); one patient showed a good response (4.545%), one showed a fair response (4.545%) and one showed a poor response (4.545%) at the end of three‐months follow up. The difference was statistically significant; the P value at the three months follow‐up was 0.002. The cumulative clearance rate after the first, second, and third treatment sessions was 58.4%, 77.7%, and 89.9% respectively. Recurrence was seen in only one patient (4.545%). Side effects were generally mild and didn't prevent normal activity. Conclusion: Long pulsed ND:YAG laser 532 nm appears to be an effective method for treatment of plane warts. [ABSTRACT FROM AUTHOR]

A raised plaque that contained histological evidence of papillomavirus infection and sequences from a novel papillomavirus type developed close to the ear canal of a 14‐year‐old West Highland white terrier. The plaque was excised, and further plaques developed within the same area of pinna. [ABSTRACT FROM AUTHOR]

Background: The human papillomavirus that causes warts is usually harmless, and it can infect any part of the skin or mucous membranes. Despite the availability of several treatments, warts often return, and scarring, pigmentation changes, and recurrence are all possible side effects. Aim: Intralesional vitamin D3 was employed as an immunotherapy for cutaneous warts in the current investigation. Materials and Methods: In Al‐Sadr Medical City in the city of Al‐Najaf Al‐Ashraf, a skin clinic conducted a therapeutic clinical experiment. A total of 204 cutaneous warts were examined in 40 patients (14 men and 26 females). Vitamin D3 solution of the dose (600 000 IU) was injected into the lesions' bases, with 0.2 mL per patient. Each session could only inject up to five warts. The injections were given every 2 weeks for a total of four times. Instructing patients to forego the use of any topical or oral medication was also a part of the protocol. Each patient was evaluated for recurrence risk before each therapy and then again 6 months later. Result and Discussion: There was a wide range of patient ages in this study, from 20 months to 52 years. About 65% of the cases included females. When looking at the many kinds of warts, the most prevalent was the common wart (71.6%). After four treatments, a positive response was considered to have occurred when all lesions had disappeared, a partial response when more than half of the lesions had disappeared, and no reaction when less than half of the lesions had disappeared. The final tally was 81.9% for those who responded in whole, 11.3% for those who responded partially, and 6.9% for those who did not respond at all. Next‐session complete response rates were 12.7%, 29.9%, 54.9%, and 81.9%, respectively. Thirteen people experienced adverse symptoms, most noticeably minor swelling and itching. Within 6 months of follow‐up, warts had completely disappeared for all patients with a partial or modest response except one who had no reaction. Conclusion: Vitamin D3 administered intralesional is an effective and low‐cost treatment for cutaneous warts. [ABSTRACT FROM AUTHOR]

Background: Plantar warts are benign, epidermal neoformations, viral, and easily transmitted. Although 30% of these warts disappear spontaneously, the American Association of Dermatology recommends treatment if they cause pain or bleeding. Objectives: The aim of this study was to determine the efficacy of Dermojet® infiltration using a solution composed of equal parts of 0.9% saline and 2% mepivacaine in the treatment of plantar warts, and to identify the type of necrosis achieved at 7–10 days after the infiltration (M1 sample) and at 15–17 days (M2 sample). Method: In this analytical prospective observational study, 102 histories were reviewed by the same researcher. The patients were treated with this technique at four private podiatry clinics. Results: A total of 61.8% of the patients were male. The patients' mean age was 26.6 ± 14.10 years. A total percentage of 78.4% of the patients achieved complete elimination of the lesion by the second evaluation and after a single infiltration. Bivariate analysis revealed a significant inverse relationship between treatment efficacy and a history of previous disease (p < 0.001) and the period of evolution of the lesion (p < 0.001; 95% CI [0.78–7.91]). Multivariate linear regression analysis revealed an association with the number of evaluation sessions (p < 0.001) and with previous illnesses (p = 0.014). A total percentage of 82.35% presented partial necrosis in the M1 sample and 76.92% had complete necrosis in the M2 sample. Conclusions: In 78.4% of the patients considered, the plantar warts treated disappeared after a single infiltration. The variables associated with treatment efficacy were the number of follow‐up visits and the existence of associated diseases. [ABSTRACT FROM AUTHOR]

Background: Plantar warts, or verrucae plantaris, are common lesions causing considerable pain during weightbearing activity. Although current treatment modalities have low success rates, microwave therapy has been introduced as a promising intervention. This study aimed to determine the effectiveness of microwave therapy for the treatment of plantar warts and to determine the clinical factors associated with plantar wart resolution. Methods: A retrospective analysis of 150 plantar warts from 45 patients treated with microwave therapy was undertaken. Binomial regression was conducted to explore clinical characteristics (age, gender, immunosuppression, impaired healing, multiple vs single wart, location of lesion, lesion diameter) associated with lesion resolution. Results: Of the total 150 plantar warts treated with microwave therapy, 125 (83.3%) warts resolved and 25 (17%) warts did not resolve. The mean (SD) total treatment sessions for resolved lesions was 2.8 (1.0). Decreasing age (P = 0.046) was the only clinical characteristic associated with resolution. Conclusions: This retrospective study has shown that plantar warts may be resolved with two to three sessions of microwave therapy, which may be more successful in younger populations. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Well‐differentiated variant of squamous cell carcinoma. Slow growing, exophytic, cauliflower‐like growth easily confused with a viral wart. Cutaneous, anogenital, and oral variant exist. Risk factors for oral variant include alcohol and smoking. Histopathologically exhibits lobules with a pushing margin and blunt borders. Verrucous carcinoma (VC) is a low‐grade variant of squamous cell carcinoma with specific clinicopathologic features and good prognosis when affecting skin. We report the case VC of lip in a‐70‐year‐old lady. She underwent surgical excision with excellent outcomes. A brief review of the literature is provided. [ABSTRACT FROM AUTHOR]

Background: This guideline is an update to the 2014 edition of the European guideline for the management of balanoposthitis. Balanoposthitis describes inflammation of the glans penis and prepuce and is caused by a range of disparate conditions including infection, dermatoses and premalignancy. Objective: The main objectives of this guideline are to aid recognition of the symptoms and signs and complications of penile skin conditions and to offer recommendations on the diagnostic tests and treatment for a selected group of these conditions. Methods: The previous guideline was updated following a literature review and priority was given to randomized controlled trial and systematic review evidence. Results: The updated guideline includes amended management for infective balanitis to provide clear guidance for Group A streptococcal infections, management of on going Lichen sclerosus (to include circumcision and supportive management to reduce the recurrence of genital herpes and warts), additional regimens for Zoonoid change, use of calcineurin inhibitors in management and risk of premalignancy and change of nomenclaturefrom Premalignant conditions to Penile Intraepithelial neoplasia (PeIN). Conclusion: Balanoposthitis has a widerange of causes high quality evidence specific to the management of penile disease is not available for all the conditions described. [ABSTRACT FROM AUTHOR]

PCR and culture turned negative simultaneously on systemic therapy except for 2 patients (15%), where PCR turned negative 4 weeks after culture without continued systemic therapy. To our knowledge, this is the first description of topical 5-fluorouracil being used as an effective treatment for trichodysplasia spinulosa and, pending confirmation, may represent a more cost-effective and widely available treatment than topical cidofivir. Efficacy and safety of dupilumab treatment up to 1 year in infants and preschool children wit... Michael J. Cork 1, Amy S. Paller 2,3, Elaine C. Siegfried 4,5, Jing Xiao 6, Randy Prescil... 1 Sheffield Dermatology Research, University of Sheffield Sheffield Children's Hospital, Shef... B Objectives: b To report dupilumab efficacy and safety in children aged from 6 months to 5 years with moderate-to-severe atopic dermatitis (AD) treated for up to 1 year. B Discussion: b Dupilumab treatment for 1 year provides sustained improvement in signs of AD and quality of life with an acceptable safety profile in patients aged from 6 months to 5 years with moderate-to-severe AD. [Extracted from the article]

Background: Recurrent respiratory papillomatosis (RRP) is a currently incurable benign neoplasm caused by human papilloma virus (HPV) infection. It usually reduces voice, respiratory, and general quality of life, and is sometimes life‐threatening. Patients usually need repeated operations. The use of adjuvant bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor A, has been described in several case reports, with a good efficacy and safety profile. Methods: We report the cases of five patients with aggressive RRP who were treated with adjuvant systemic bevacizumab in a single Belgian tertiary center. Results: A complete response was achieved in four patients after a median of 4.5 months, and a partial response in one. In all cases, the number of surgeries was drastically reduced, and quality of life improved. Toxicity was easily managed. Conclusions: Systemic bevacizumab seems to be an effective and safe adjuvant treatment for aggressive RRP. [ABSTRACT FROM AUTHOR]

Background: Immunostimulatory and antiproliferative therapies have been widely used for the treatment of multiple warts. Recently, anti‐HPV activity of ionic contra viral therapy (ICVT) which is comprised of combined digoxin and furosemide has been demonstrated. Aim: To evaluate and compare the effectiveness and safety of intralesional injection of Candida antigen, vitamin D3, and combined digoxin and furosemide in the treatment of multiple warts. Patients and Methods: Seventy‐five patients with numerous warts were randomly assigned to one of three equal groups: Candida antigen, vitamin D3, or a combination of digoxin and furosemide. In the Candida antigen group, injections into the biggest wart were done. In the vitamin D3 and combined digoxin/furosemide groups, the agent was injected into each wart with a maximum of five injected warts. Injections were repeated every 2 weeks until clearance or for a total of five sessions. Results: There was a statistically significant difference in the overall therapeutic response among the studied groups in favor of the intralesional Candida antigen group (60%), followed by the vitamin D3 group (48%) and the ionic contraviral therapy group (28%) (p = 0.02). However, the difference between both Candida antigen and vitamin D groups was not significant (p = 0.59). Conclusions: Intralesional Candida antigen immunotherapy and vitamin D3 antiproliferative therapy are significantly more effective than ICVT. Limitations: Short follow‐up period and relatively small sample size. [ABSTRACT FROM AUTHOR]

Design: Interventional, prospective, four arm randomized control. Setting: Outpatient department, Department of Dermatology, Venereology and Leprology, AIIMS Jodhpur (Rajasthan), India. Participants: Two hundred patients. Methods: The intervention administered in the groups were normal saline (A), vitamin D3 (B), MIP (C), and MMR (D). The injections were given into the largest wart at 2‐weekly intervals until complete clearance or for a maximum of seven sittings. Post‐treatment clearance of the injected wart and the distant wart was compared on the basis of change in wart number, percentage clearance, and mean time to complete clearance. Side effects were recorded. Results: A total of 197 patients were recruited. The mean percentage improvement in the injected and non‐injected warts was 68.4% and 66.8%, respectively. Intention to treat analysis (ITT) showed that complete clearance of lesions in injected wart occurred in placebo, vit D3, MMR, and MIP arms in 64%, 66%, 58%, and 55% patients, respectively (p > 0.05), while in the non‐injected warts in 62%, 64%, 52%, and 53%, respectively (p > 0.05). The mean time to achieve complete clearance of wart was fastest in MIP at 7.1 weeks followed by MMR at 7.2 weeks, VIT D3 at 7.4 weeks and in placebo group 7.8 weeks (p > 0.05). Side effects noted were fever, pain, erythema, and swelling which was highest in VIT D3 group (p < 0.05). Conclusion: The efficacy of immunotherapies was comparable to placebo with minimal side effects. [ABSTRACT FROM AUTHOR]

Numerous studies have investigated the efficacy of intralesional immunotherapy for warts, but there are a lack of studies investigating the efficacy of alternative intralesional immunotherapies following failure of initial intralesional immunotherapy. In this retrospective study, we aimed to investigate the efficacy of intralesional measles, mumps, and rubella vaccine for the treatment of pediatric warts following failure of intralesional therapy with Candida antigen. Following intralesional measles, mumps, and rubella vaccine administration, 8/51 (15.5%) patients had complete resolution of their warts, 6/51 (12%) had near complete resolution, 19/51 (37%) had partial improvement, 12/51 (23.5%) had no change, and 6/51 (12%) had worsening. Although limited by retrospective nature and low sample size, our results demonstrate that intralesional immunotherapy with measles, mumps, and rubella vaccine provides an alternative therapeutic option for the treatment of recalcitrant pediatric warts in patients who fail to respond to intralesional Candida antigen. [ABSTRACT FROM AUTHOR]

For patients with acquired immunodeficiencies, the median interval between the onset of immunosuppression and the presentation of AEV lesions was 5 years (range 3-7 years). However, the risk of skin cancer development in AEV is largely unknown, mainly due to lack of studies with long-term follow-up.[2] In this study, we summarize the clinical and pathologic features of seven patients with AEV diagnosed between January 1992 and November 2019. Epidermodysplasia verruciformis (EV) is a rare inherited disorder, often due to mutations in the I EVER1 i or I EVER2 i genes, characterized by increased susceptibility to persistent human papillomavirus infections and increased skin cancer development.[1] Acquired epidermodysplasia verruciformis (AEV) is a rare, acquired, and sporadic disorder clinically identical to hereditary epidermodysplasia verruciformis (EV) classically described in individuals with primary or acquired immunodeficiency.[[2]] Clinically, AEV is indistinguishable from genetic EV, presenting with flat-topped, warty papules and pityriasis versicolor-like macules predominantly affecting the sun-exposed skin. [Extracted from the article]

Key Clinical Messase: Periungual warts are frequently encountered in the field of dermatology. Here, we describe the case of a 69‐year‐old individual who presented with hand warts. The wart growth extended to the finger stump, resulting in a soft tissue defect on the fingertip of the right thumb. A treatment approach involving superficial x‐ray therapy in combination with tretinoin was employed to address this finding. The warts disappeared after completing 26 days of the treatment regimen. Fingertip soft tissue defects due to periungual warts are a rare occurrence in clinical settings. This report serves as the first documented case of such a problem successfully managed with the treatment approach mentioned above. [ABSTRACT FROM AUTHOR]

A 45-year-old man born of a non-consanguineous marriage was referred for treatment of "atypical warts" on his hands, elbows, and axillae since childhood. On clinical examination, the patient had a hoarse voice, skin-colored verrucous papules on the dorsal aspects of his hands, and hyperkeratotic verrucous plaques on elbow extensor surfaces as well as both axillae and his gluteal cleft (Figure 1). Patients can present with skin colored to red-brown papules and nodules on the face, hands, neck, and trunk. [Extracted from the article]

A case report published in the International Journal of Dermatology discusses the potential use of topical tirbanibulin ointment 1% as a new treatment for recalcitrant plantar warts. The report highlights the challenges of treating plantar warts and the need for innovative approaches. Tirbanibulin, an inhibitor of tubulin polymerization, has shown promising results in inducing apoptosis in rapidly dividing cells infected by HPV. The case study describes the successful treatment of a large plantar wart with tirbanibulin cream, suggesting the need for further research to establish its efficacy and safety profile. [Extracted from the article]

Numerous prey traits are the result of the pervasive evolutionary pressure imposed by predators. Mirroring their fundamental role in the fitness of prey, some antipredator defences can evolve into elaborate strategies. Such is the case of the Iberian ribbed newt (Pleurodeles waltl), a semiaquatic urodele that inhabits multiple types of inland waterbodies in central and southern Iberian Peninsula and north‐western Africa. It possesses sharp, protractile ribs, which can thwart predators by emerging through skin 'warts' they pierce, becoming impregnated with the toxicants these warts produce, and making the newts difficult to swallow. Plus, the orange colour of these warts contrasts with the predominantly dull dorsum.In this work, I studied the interactions between the number of these warts, the saliency of wart colour against dorsum colour of each individual (i.e., the difference in colour between the warts and the dorsum), rib response time (i.e., the time needed for the ribs to emerge in response to a standardised stimulus), body size, and locomotor performance in males and females in either their aquatic or terrestrial stage. I also conducted a field experiment to determine whether predators more frequently attacked plasticine models with conspicuous or inconspicuous warts.I found that wart colour saliency functions as a decoy, attracting predator attacks towards this well‐protected body part. Plus, many of the antipredator defences studied, namely the number of warts, their colour saliency, rib response time, body size, and locomotor performance, were interrelated.Accordingly, more salient warts indicated a faster rib response, suggesting that these defences are coordinated with each other. Plus, locomotion was considerably slower in the terrestrial than in the aquatic stage. Moreover, warts were more salient, and thus more efficient attracting predator attacks, in newts in the slower terrestrial stage. However, rib response was faster in the aquatic stage, which coincides with the newt's activity peak, and therefore with the height of its conspicuousness to predators. Remarkably, faster newts display less salient warts and a slower rib response, which suggests a trade‐off between both defences. Nonetheless, some of these trends are reversed in females, among which faster individuals also display a faster rib response. This could be a likely consequence of reduced predation pressure.These results further the understanding of how prey integrate and tune multiple antipredator defences according to factors that influence predation pressure, such as sex and life stage. [ABSTRACT FROM AUTHOR]

The most common cancer caused by human papillomavirus (HPV) infection in the United States is oropharyngeal cancer (OPC), and its incidence has been rising since the turn of the century. Because of substantial long‐term morbidities with chemoradiation and the favorable prognosis of HPV‐positive OPC, identifying the optimal deintensification strategy for this group has been a keystone of academic head‐and‐neck surgery, radiation oncology, and medical oncology for over the past decade. However, the first generation of randomized chemotherapy deintensification trials failed to change the standard of care, triggering concern over the feasibility of de‐escalation. National database studies estimate that up to one third of patients receive nonstandard de‐escalated treatments, which have subspecialty‐specific nuances. A synthesis of the multidisciplinary deintensification data and current treatment standards is important for the oncology community to reinforce best practices and ensure optimal patient outcomes. In this review, the authors present a summary and comparison of prospective HPV‐positive OPC de‐escalation trials. Chemotherapy attenuation compromises outcomes without reducing toxicity. Limited data comparing transoral robotic surgery (TORS) with radiation raise concern over toxicity and outcomes with TORS. There are promising data to support de‐escalating adjuvant therapy after TORS, but consensus on treatment indications is needed. Encouraging radiation deintensification strategies have been reported (upfront dose reduction and induction chemotherapy‐based patient selection), but level I evidence is years away. Ultimately, stage and HPV status may be insufficient to guide de‐escalation. The future of deintensification may lie in incorporating intratreatment response assessments to harness the powers of personalized medicine and integrate real‐time surveillance. [ABSTRACT FROM AUTHOR]

One immunocompromised patient was lost after five PDT sessions, thus the therapeutic outcome was evaluable in 17 patients (Table 1). Fourteen patients achieved a complete response (Figure 1a,b), one patient showed clearance of all but one wart, and two patients (both immunodeficient) were treatment failures. In two-thirds of the patients (10/15), the maximum treatment response was already apparent at 3 months and in another three patients at 6 months after PDT. [Extracted from the article]

Background: An understanding of the prevalence patterns of skin diseases in children in Botswana is needed to guide national dermatological policy development, training, and resource allocation to improve patient care. Objective: To describe local skin disease patterns in children aged 0–18 years presenting for dermatologic care in Botswana. Methods: A retrospective review of records from 1st January 2011 to 31st December 2016 was conducted at the outpatient dermatology clinic of Princess Marina Hospital (PMH) in Gaborone, Botswana and outreach clinic sites. Results: There were 4413 pediatric visits constituting 18.6% of all dermatology visits. There was a slight male predominance of 1.2:1. The majority of disorders were noninfectious 80.1% (3537/4413) versus infectious 14.6% (645/4413), with 5.2% (231/4413) unclassified. In the noninfectious category, two‐thirds were inflammatory, followed by disorders of nails, skin appendages, and pigmentary disorders. Atopic dermatitis was the most common inflammatory disorder. Over half of infectious skin diseases were viral, followed by fungal and bacterial disorders. In the HIV‐related disorders, the majority were verrucae 94% (108/115) followed by Kaposi sarcoma. The nine most common skin diagnoses accounted for close to 70% of all skin diseases seen at the clinic, and these included atopic dermatitis (almost half of all cases), followed by verruca, acne, and vitiligo. Conclusion: There is a high burden of skin disorders in children in Botswana. In our cohort, a small number of skin conditions made up the vast majority of pediatric diagnoses. This information can be used to guide dermatology training and resource allocation to better manage these common diseases. [ABSTRACT FROM AUTHOR]

Background: Immunotherapy has emerged as a critical therapeutic tool for the treatment of warts. Immunotherapy for warts is currently restricted to recalcitrant lesions. A small number of regimens appear to be extremely effective. Furthermore, there is a scarcity of evidence‐based research. Objective: Furthermore, in the majority of cases, their safety and effectiveness have not been evaluated in double‐blind, controlled clinical trials, making the reproducibility of many of the listed treatments difficult to analyze and a possible placebo effect difficult to rule out. Methods: Analyzing and discussing different types of systemic immunotherapy. The different types of immunotherapy for warts are mentioned in this report. Results: Systemic immunotherapeutic modalities commonly used in the treatment Echinacea, propolis, oral retinoids, glycyrrhizinic acid, levamisole, cimetidine, and zinc sulfate have all been reported as effective treatment modalities for different types of warts. Conclusion: Immunotherapy has emerged as one of the most important therapeutic modalities for warts. Such treatment is required not only for recalcitrant or multiple lesions, but also in the majority of treated cases. [ABSTRACT FROM AUTHOR]

Background: Management of multiple recalcitrant common warts represents a therapeutic challenge. Both oral isotretinoin and acitretin have shown a promising efficacy in the treatment of various types of warts. However, a comparative study of the two medicines in wart treatment has not yet been conducted. Objective: The aim of this study was to assess the efficacy and adverse effects of oral isotretinoin versus acitretin in the treatment of multiple recalcitrant common warts. Methods: This study was conducted on 75 adult male patients with recalcitrant multiple common warts. The patients were randomly assigned to three groups: group 1 (30 patients) received oral isotretinoin, group 2 (30 patients) received acitretin, and group 3 received oral placebo (15 patients). The treatment was given daily until complete clearance or for a maximum of 3 months. Results: Complete clearance of the treated lesions was observed in 18 patients (60%) of the isotretinoin group, in 22 patients (73.3%) of the acitretin group, and in 0 patients (0%) of the placebo group. A statistically significant difference was observed in the therapeutic response between the treatment groups, and the placebo group was observed. Adverse effects of the used drugs were mild and transient. Conclusion: Oral isotretinoin and acitretin are promising effective modalities with minimal side effects for the treatment male patients with multiple recalcitrant common warts with a relative superiority of acitretin. [ABSTRACT FROM AUTHOR]

Acquired lymphangiectasia (AL) represents superficial lymphatic dilatation caused by different processes. It is a consequence of lymphatic damage by an external cause; leading to obstruction of local lymphatic drainage.1 We report a case of AL of the breast in a 45‐year‐old woman mimicking warts. [ABSTRACT FROM AUTHOR]

Background: Warts are common in children and can be difficult to treat. Many treatments for warts are destructive and painful in contrast to intralesional immunotherapy using different types of antigens. Aim: To evaluate the efficacy, safety, and tolerability of intralesional purified protein derivative (PPD) versus intralesional zinc sulfate 2% in the treatment of pediatric warts. Methods: This randomized clinical trial included 120 children with multiple warts divided into two equal groups. Group Ⅰ received intralesional 10 IU (0.1 ml) of PPD, group Ⅱ received intralesional zinc sulfate 2% in the largest wart every 2 weeks till improvement or for a maximum five treatment sessions. The follow‐up period was 6 months after the last treatment session. Results: The overall response was equal in both groups (81.7%), but the response of the injected wart was higher in the zinc sulfate group (93.4%) versus PPD group (83.3%) with no significant difference. The highest cure rates were after the 5th session in the PPD group and the 1st session in the zinc sulfate group with slightly lower numbers of sessions needed for cure in the zinc sulfate group (3 sessions) versus the PPD group (4 sessions). The zinc sulfate group showed statistically significant higher rates of complications (pain, inflammation, necrosis, and scar) than PPD group. The zinc sulfate group showed non‐significant higher rates of recurrence during the follow‐up period. Conclusion: Both intralesional PPD and zinc sulfate 2% are effective in pediatric warts with higher safety profile of PPD. [ABSTRACT FROM AUTHOR]

Background: There are various available therapies for plane warts; however, no specific therapy has been established as entirely effective. Objective: The aim of work was to assess the effectiveness and safety of topically hydrogen peroxide (HP) 40% solution in treating the plane warts. Subjects and methods: The study included 30 patients diagnosed clinically as plane warts. Topical HP 40% was applied with a single‐use wood end of a cotton swab soaked with the solution to minimize filtration of effective drug to the surrounding areas. Duration of the treatment was planned to be 4 sessions for each lesion with 2‐week interval and a 3‐month follow‐up period after treatment completion to detect any recurrence. Results: Complete clearance of plane warts was observed in 27 (90%), and there was no recurrence of the lesions after a 3‐month follow‐up period. Conclusion: HP solution especially the 40% concentration may be considered a promising line of treatment for non‐genital warts. It is a very effective, safe, cheap, and easy‐to‐use new topical treatment for non‐genital warts. [ABSTRACT FROM AUTHOR]

This article discusses a case of botryomycosis-like Klebsiella balanitis in a male patient. The patient presented with painful, enlarging keratotic lesions on his glans penis. A biopsy revealed inflammation and the presence of Klebsiella pneumoniae. The patient was treated with oral cephalexin and experienced complete resolution of the lesions. The article emphasizes the risks of self-treatment and highlights the importance of seeking medical consultation for dermatological conditions. [Extracted from the article]