Genital Lichen Sclerosus in Male Patients: A New Treatment with Polydeoxyribonucleotide

574 Background: In multicenter randomized phase 2 study (FARETES) we showed that male patients with mRCC receiving targeted therapy had significantly less fatigue and better symptom control with testosterone undecanoate (T) (MASCC 2018, LBA004). Here we described exploratory endpoints in FARETES study. Methods: Sixty male patients with clear cell mRCC, normal PSA level, low testosterone level and no evidence of hypothyroidism receiving first-line sunitinib or pazopanib with fatigue were randomly assigned (1:1) to either T (Nebido, 1,000 mg) and targeted therapy or targeted therapy alone (control group). T was injected intramuscular deeply on Day 1 of a new treatment cycle. Exploratory endpoints included rate of adverse events (AE) of targeted therapy, duration of targeted therapy, objective response rate (ORR), progression-free survival (PFS) and overall survival (OS). Results: As of the data cutoff on October 17, 2018, median (range) follow-up was 15.2 (9.9 -16.5) months. No unexpected toxicity of T was observed. Grade 3-4 targeted therapy-related AE occurred in 11 (37%) and 3 (10%) patients in the control group and T group, respectively. Discontinuation due to AE was observed in 3% (1/30) of patients in the T group and in 17% (5/30) of patients in the control group. ORR and PFS were significantly better in the T group (all P < 0.05, Table). Median OS was not reached in either group. Clinical trial information: NCT03379012. Conclusions: T therapy could decrease rate of serious AE of targeted therapy. Male mRCC patients receiving T had longer duration of targeted therapy, better PFS and ORR. Larger trials are needed to evaluate efficacy of T in this group of patients.[Table: see text]

Download Full-text

Extragenital lichen sclerosus arising in tattooed skin

BMJ Case Reports ◽

10.1136/bcr-2021-246216 ◽

2022 ◽

Vol 15 (1) ◽

pp. e246216

Author(s):

Aarthy Kanmany Uthayakumar ◽

Georgios Kravvas ◽

Christopher Barry Bunker

Keyword(s):

Rare Case ◽

Lichen Sclerosus ◽

Inflammatory Condition ◽

Koebner Phenomenon ◽

Chronic Inflammatory Condition ◽

Anogenital Area ◽

Male Patients

Lichen sclerosus (LSc) is a chronic inflammatory condition commonly affecting the anogenital area, with extragenital involvement seen in less than 1%–20% of cases. Concomitant extragenital and genital LSc is extremely rare in male patients. The Koebner phenomenon is a recognised feature of LSc; here we present a rare case of extragenital LSc occurring in tattooed skin.

Download Full-text

Re: Histological Evidence of Urethral Involvement in Male Patients With Genital Lichen Sclerosus: A Preliminary Report

The Journal of Urology ◽

10.1016/j.juro.2011.12.005 ◽

2012 ◽

Vol 187 (4) ◽

pp. 1512-1512

Author(s):

Xiaoming Zhang ◽

Weilie Hu

Keyword(s):

Preliminary Report ◽

Lichen Sclerosus ◽

Histological Evidence ◽

Male Patients

Download Full-text

1167. Trends in Multi-Drug-Resistant Gonorrhea, Gonococcal Isolate Surveillance Project, United States, 1987–2016

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1000 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S352-S352

Author(s):

Sancta St. Cyr ◽

Ellen Kersh ◽

Hillard Weinstock ◽

Elizabeth Torrone

Keyword(s):

United States ◽

Antimicrobial Susceptibility ◽

Treatment Options ◽

The United States ◽

Drug Resistant ◽

Appropriate Treatment ◽

High Prevalence ◽

Agar Dilution ◽

Male Patients ◽

New Treatment

Abstract Background Neisseria gonorrhoeae’s ability to develop resistance to antibiotics used for treatment and a limited development of new therapies have made this organism one of three urgent threat pathogens in the United States. We provide the first report of US trends in multi-drug-resistant (MDR) and extensively-drug-resistant (XDR) gonorrhea. Methods The Gonococcal Isolate Surveillance Project (GISP) monitors trends in antimicrobial susceptibility in N. gonorrhoeae in the United States. Antimicrobial susceptibility testing by agar dilution is performed on urethral isolates from male patients at participating STD clinics. Minimum inhibitory concentration (MIC) are used to identify isolates with resistance or reduced susceptibility using the following criteria: fluoroquinolones (ciprofloxacin [MIC ≥1.0 μg/mL]) and elevated MICs to cephalosporins (cefixime [MIC ≥0.25 μg/mL], ceftriaxone [MIC ≥0.25 μg/mL]) and macrolides (azithromycin [MIC ≥1.0 μg/mL before 2005 and ≥2.0 μg/mL 2005–2016]). In this analysis, MDR is defined as resistance or elevated MICs to ≥2 classes of antimicrobials; XDR as resistance or elevated MICs to ≥3 classes. This classification excludes penicillin and tetracycline due to their long history and high prevalence of gonococcal resistance. Results During 1987–2016, 159,445 isolates were collected through GISP. In 1998, the first MDR strains were identified. Although only 0.04% of isolates that year, these isolates showed elevated MICs to both cephalosporins and macrolides. By 2010, 1.0% of GISP isolates were MDR with elevated MICs or resistance to two of the cephalosporins, macrolides, or fluoroquinolones. In 2011, the proportion of isolates that were MDR peaked at 1.3%. In 2016, after minor fluctuations, 1.1% of GISP isolates were considered MDR. Only one occurrence of XDR, in 2011, has been seen in GISP. The strain was resistant to fluoroquinolones with elevated MICs to both cephalosporins and macrolides. Conclusion MDR and XDR gonorrhea have remained low over the past three decades; however, dual treatment with cephalosporins and macrolides is the last remaining recommended therapy for N. gonorrhoeae. Until new treatment options become available, a combination of surveillance and ensuring appropriate treatment are needed to delay further resistance. Disclosures All authors: No reported disclosures.

Download Full-text

Histological Evidence of Urethral Involvement in Male Patients With Genital Lichen Sclerosus: A Preliminary Report

The Journal of Urology ◽

10.1016/j.juro.2011.02.060 ◽

2011 ◽

Vol 185 (6) ◽

pp. 2171-2176 ◽

Cited By ~ 27

Author(s):

Guido Barbagli ◽

Francesco Mirri ◽

Michele Gallucci ◽

Salvatore Sansalone ◽

Giuseppe Romano ◽

...

Keyword(s):

Preliminary Report ◽

Lichen Sclerosus ◽

Histological Evidence ◽

Male Patients

Download Full-text

Current approaches to the treatment and management of male patients with genital lichen sclerosus

Klinicheskaya dermatologiya i venerologiya ◽

10.17116/klinderma201716370-74 ◽

2017 ◽

Vol 16 (3) ◽

pp. 70

Author(s):

A. A. Sokolova ◽

N. F. Zatorskaia ◽

O. V. Medvedeva ◽

V. N. Grebenyuk ◽

O. R. Katynina

Keyword(s):

Lichen Sclerosus ◽

Male Patients

Download Full-text

Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA

ISRN Dermatology ◽

10.5402/2011/241953 ◽

2011 ◽

Vol 2011 ◽

pp. 1-11 ◽

Cited By ~ 4

Author(s):

A. W. Rafi ◽

R. M. Katz

Keyword(s):

Pilot Study ◽

Treatment Regimen ◽

Rapid Growth ◽

The Other ◽

Androgenic Alopecia ◽

Significant Growth ◽

Prospective Pilot Study ◽

Male Patients ◽

New Treatment ◽

Three Components

Background. We examined the efficacy of a new regimen to treat AGA, with attention to male patients who are atopic. Objective. To assess the efficacy of a four-part regimen for the treatment of AGA in atopic and nonatopic patients. NuH Hair is a novel topical combination of finasteride, dutasteride, and minoxidil, which is blended in a hypoallergenic lotion. The other three components included Rogaine foam, Propecia, and ketoconazole shampoo. Methods. A prospective pilot study was conducted in 15 patients. All patients were assessed for the presence of atopy. Each patient served as their own control. All patients were treated specifically with NuH Hair and were given the option to add any of the other components of the protocol to their regimen. Photographs were taken of each patient's scalp at months 0, 1, 3, 6, and 9. Results. All 15 patients demonstrated significant growth of hair. In those patients who utilized all 4 components, significant growth was achieved in as little as 30 days. In those patients who choose only to utilize NuH Hair, significant growth was demonstrated after 3 months. Conclusion. Aggressively treating AGA achieves significant and rapid growth of new hair. This is effective in atopic and nonatopic male patients.

Download Full-text

Lichen sclerosus et atrophicus in pediatric and adult male patients with congenital and acquired phimosis

Medicina ◽

10.3390/medicina44060060 ◽

2008 ◽

Vol 44 (6) ◽

pp. 460 ◽

Cited By ~ 11

Author(s):

Daiva Jasaitienė ◽

Skaidra Valiukevičienė ◽

Daiva Vaitkienė ◽

Mindaugas Jievaltas ◽

Vidmantas Barauskas ◽

...

Keyword(s):

Adult Male ◽

Pediatric Surgery ◽

Lichen Sclerosus ◽

Lichen Sclerosus Et Atrophicus ◽

Equal Frequency ◽

Male And Female ◽

Histological Features ◽

Histological Characteristics ◽

Male Patients ◽

Female Genital

Lichen sclerosus et atrophicus is a chronic inflammatory sclerotic and atrophic disease of unknown cause that predominantly affects male and female genital skin. This study was designed to evaluate histological characteristics of congenital and acquired phimoses among pediatric (n=60) and adult (n=60) male patients who were admitted for circumcision to the Clinics of Urology and Pediatric Surgery of Kaunas University of Medicine Hospital between 2000 and 2003 and to determine the rate of lichen sclerosus et atrophicus and other histological diagnoses among them. This study demonstrates that 45.1% of congenital and 62.3% of acquired phimoses show histological signs of lichen sclerosus et atrophicus. The rate of lichen sclerosus et atrophicus was statistically significantly higher among patients with acquired than congenital phimosis. Boys with acquired narrowing of prepuce were statistically significantly 3.9 times more likely to develop lichen sclerosus et atrophicus than those with congenital phimosis. There were no statistically significant differences between rates of lichen sclerosus et atrophicus and other dermatological diagnoses among pediatric and adult male patients if the type of phimosis (acquired or congenital) was considered. Histological features of lichen sclerosus et atrophicus and other histological diagnoses in boys and men with phimosis were detected with equal frequency irrespective the age of the subjects. The rate of lichen sclerosus et atrophicus was similar among all boys (56.7%) and men (53.3%) treated for phimosis. Only the type of phimosis had a statistically significant influence on the rate of lichen sclerosus et atrophicus and other histological diagnoses.

Download Full-text

Genital lichen sclerosus developing around ‘ectopic’ urethral orifices supports the role of occlusion and urine in its pathogenesis

International Journal of STD & AIDS ◽

10.1177/0956462416688159 ◽

2017 ◽

Vol 28 (9) ◽

pp. 940-942 ◽

Cited By ~ 2

Author(s):

Vishal Gupta ◽

Somesh Gupta

Keyword(s):

Genetic Susceptibility ◽

Lichen Sclerosus ◽

Contributing Factors ◽

Penile Shaft ◽

Local Trauma ◽

Male Patients

Several factors such as genetic susceptibility, autoimmunity, hormones, infections, local trauma, urine, and occlusion have been speculated to play a role in the pathogenesis of lichen sclerosus. We report two male patients with lichen sclerosus around ‘ectopic’ urethral openings and the opposing surfaces of the penile shaft and scrotum, providing further evidence in support of urine and occlusion as contributing factors in the development of lichen sclerosus.

Download Full-text