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BACKGROUND: Pseudoxanthoma elasticum (PXE) is a rare, genetic, metabolic disease with autosomal recessive inheritance caused by mutations in the ABCC6 gene. The lack of functional ABCC6 protein leads to ectopic mineralization that is most apparent in the elastic tissues of the skin, eyes, and blood vessels. Dermatologic manifestations consist of small yellow papules on the nape and sides of the neck and in flexural areas that coalesce into reticulated plaques resembling the cobblestone aspect, and then the skin becomes loose and wrinkled. Histopathologic findings provide characteristic clues such as short, fragmented, clumped, and calcified mid-dermal elastic fibers. CASE PRESENTATION: A 27-year-old Albanian female was referred to the dermatology clinic with skin complaints for approximately 17 years. On physical examination, we observed “cobblestone pattern” lesion located in the anterior, lateral, and posterior aspects of the neck, bilateral axillary, inguinal, antecubital, and popliteal regions, and periumbilical area. A biopsy was performed and the histopathology confirmed the typical changes in the dermis because of ectopic mineralization. The funduscopy revealed the “peau d’orange” aspect, bilateral angioid streaks but no neovascularization. Carotid echography showed minimal intimate thickening with flow acceleration but without significant stenosis of the right common carotid artery (ACC). Different laboratory exams were conducted that resulted within the normal range. CONCLUSION: There is no specific treatment, and therapeutical management is based on prevention, tracking, and follow-ups to increase surveillance of clinical complications through a multidisciplinary team. The dermatologist is usually the first who faces Pseudoxanthoma elasticum manifestations. Therefore, the dermatologist should provide the patient with the best therapeutical and preventive approaches.

The term "Diabetes mellitus" encompasses a heterogeneous group of disorders characterized by insulin hyposecretion and/or insensitivity. Type 1 DM is a chronic autoimmune disease associated with selective destruction of insulinproducing pancreatic b-cells. A variety of gene loci have been studied to determine their association with type 1 DM. The early studies suggested that the B8 and B15 of HLA class I antigens were increased in frequency in the diabetics compared to the control group. However, more recently the focus has shifted to the class II HLA-DR locus. It was found that DR3 and DR4 were more prevalent than HLA-B in type 1.DM than HLA-B. The nature of autoantigen(s) responsible for the induction of type 1 DM is unknown. The identification of autoantigens in type 1 DM is essential both for diagnostic purposes and for potential immunotherapeutic intervention in the disease process. Type 2 DM has a greater genetic association than type 1 DM. The 100% concordance rate in identical twins is thought to be overestimated, due to a selection or reporting bias. A population based twin study in Finland has shown a concordance rate of 40%. Environmental effect may be a possible reason for the higher concordance rate for type 2 DM than for type 1 DM. Perturbations in glucose metabolism due to insulin resistance are further exacerbated when insulin production is compromised.Insulin resistance is a characteristic feature of most patients with Type 2 diabetes mellitus.Several cross-sectional studies in non diabetic subjects on the general population or in individuals with impaired glucose tolerance (IGT)/impaired fasting glucose (IFG) have confirmed that acute-phase reactants such as CRP (and sometimes the cytokines IL-6 and TNF-┙) are positively correlated with measures of insulin resistance/plasma insulin concentration, BMI/waist circumference, and circulating triglyceride and negatively correlated with HDL cholesterol concentration. In general, increasing components of the metabolic syndrome in individuals are associated with higher levels of inflammatory markers. In subjects with IGT or IFG, IL-6 but not TNF-┙ appears to be elevated compared with individuals with normal glucose tolerance and in one study, inflammatory markers were related to insulin resistance but not to insulin secretion . Psoriasis is a chronic inflammatory disease of the skin, scalp, nails, and sometimes joints that affects 1-2 percent of the general population.Psoriasis is a clinical diagnosis. The disease is characterized by erythematous and indurate plaque which usually are covered by thick silvery white scales and can manifests as psoriatic arthritis (PsA), an inflammatory joint