Genital angiokeratomas of Fordyce 595-nm variable-pulse pulsed dye laser treatment

Penile Angiokeratomas (PEAKERs) Revisited: A Comprehensive Review

Angiokeratomas are benign vascular lesions. Genital angiokeratomas, also referred to as Fordyce angiokeratomas, usually occur on the scrotum in men and the vulva in women. Penile angiokeratoma (PEAKER) is a subtype of genital angiokeratoma in men; clitoral angiokeratoma (CLANKER) is its embryologic analog in women. The PubMed database was used to search the following words: angiokeratoma, clitoris, genital, peaker, penile, penis, rejuvenation, scrotal, scrotum and vulva. The relevant papers and references cited in those papers that were generated by the search were reviewed. The purpose of this article is to summarize the features of PEAKERs. PEAKERs have been described in 54 men. They usually appeared in younger men and had been present for a mean duration of 4 years prior to the individual seeking medical attention. Only 39% of the men had angiokeratoma-associated symptoms: usually bleeding and increasing size and less often abrupt onset, pain and pruritus. The glans penis (55.5%) and the penile shaft (35%) were the most common sites of PEAKERs; the angiokeratomas were also located on the foreskin (5.5%) or both the glans penis and penile shaft (4%). Thirty seven percent of patients with glans penis PEAKERs only had angiokeratomas on the corona. Scrotal angiokeratomas were also present in 20% of patients with PEAKERs. A solitary PEAKER was observed in 32% of the men. Most of the PEAKERs were 1-5 mm in size. The PEAKERs presented as purple, red and/or blue papules; 70% of the men's PEAKERs were more than one color. Clinical features often established the diagnosis; in addition, some of the men's angiokeratomas were biopsied or evaluated with dermoscopy. Laser therapy, in 56% of the men, was the most common treatment modality. Less common interventions included electrocautery, radiofrequency and excision. PEAKER recurrence or persistence was observed after excision (two men) or cryotherapy (one man), respectively. Several of the men (27%) decided to observe their PEAKERs without treatment.

A Case Report of Scrotal Rejuvenation: Laser Treatment of Angiokeratomas of the Scrotum

Scrotal rejuvenation encompasses not only the functional quality but also the aesthetic appearance of the scrotum. It includes medical therapy and procedural interventions to improve scrotal conditions that require morphologic restoration and/or aesthetic alteration. Rejuvenation of the scrotum may be appropriate for aging-related and non-aging-related changes concerning the hair (alopecia and hypertrichosis), the morphology (laxity and wrinkles), and/or the vascularity (angiokeratoma) of the scrotum. Angiokeratomas-typically small, asymptomatic, purple papules-may occur on the scrotum. However, these benign vascular lesions may be of cosmetic concern to the affected individuals; in addition, the angiokeratomas can become an issue of medical importance if they begin to bleed. Multiple locally destructive modalities are available for the treatment of scrotal angiokeratomas; indeed, several lasers have effectively been used to treat angiokeratomas of the scrotum. A 70-year-old man with numerous scrotal angiokeratomas experienced scrotal bleeding in the absence of prior trauma to the area or sexual activity. He presented for treatment to prevent future episodes of spontaneous bleeding from his scrotal angiokeratomas, but he also had not liked the aesthetic appearance of the previously asymptomatic angiokeratomas on his scrotum. His angiokeratomas were successfully treated with three sequential 532-nm potassium titanyl phosphate (KTP) laser sessions, which led to not only functional but also cosmetic improvement of his scrotum. In conclusion, men can develop scrotal changes due to either intrinsic (aging) or extrinsic (trauma) causes, but nonsurgical interventions and surgical procedures are available for the management of these conditions in individuals who desire to rejuvenate their scrotum.

Penile Angiokeratoma (Peaker): A Distinctive Subtype of Genital Angiokeratoma

Penile angiokeratomas (peakers) are uncommon, benign vascular tumors typically presenting as multiple lesions on the corona of the glans penis. They have been observed in 21 men. They range from 0.5 to 5 millimeters in size and initially appear in both young and old men. They are usually asymptomatic and are managed conservatively. They are rarely associated with systemic diseases. Symptomatic or cosmetically undesirable lesions can be treated with cryotherapy, electrodessication, excision, laser therapy, or sclerotherapy. We present a man with a solitary angiokeratoma of the glans penis and discuss the unique features of penile angiokeratomas.

Application of cationized magnetoferritin for magnetic field-assisted delivery of short interfering RNA in vitro

Cationized magnetoferritin is used for development of a simple, efficient, and fast delivery of short interference RNA into cells using combination of magnetophoresis for pre-concentration of siRNA-magnetoferritin complex on the surface of plated cells with subsequent application of nanosecond laser pulses producing stress waves in transfection chamber, which permeabilize cell membrane for the facilitated delivery of siRNA into the cell interior. As has been quantified using siRNA inducing cell death assay, by combination of these two physical factors we have obtained high efficiency for tested three different human carcinoma cells. Proposed method of gene silencing based on cationized magnetoferritin is a versatile and easily accessible platform with many possible applications in gene therapy.

Scrotal Rejuvenation

Genital rejuvenation is applicable not only to women (vaginal rejuvenation) but also to men (scrotal rejuvenation). There is an increased awareness, reflected by the number of published medical papers, of vaginal rejuvenation; however, rejuvenation of the scrotum has not received similar attention in the medical literature. Scrotal rejuvenation includes treatment of hair-associated scrotal changes (alopecia and hypertrichosis), morphology-associated scrotal changes (wrinkling and laxity), and vascular-associated scrotal changes (angiokeratomas). Rejuvenation of the scrotum potentially may utilize medical therapy, such as topical minoxidil and oral finasteride, for scrotal alopecia and conservative modalities, such as depilatories and electrolysis, for scrotal hypertrichosis. Lasers and energy-based devices may be efficacious for scrotal hypertrichosis and scrotal angiokeratomas. Surgical intervention is the mainstay of therapy for scrotal laxity; however, absorbable suspension sutures are postulated as a potential intervention to provide an adequate scrotal lift. Hair transplantation for scrotal alopecia and injection of botulinum toxin into the dartos muscle for scrotal wrinkling are hypothesized as possible treatments for these conditions. The interest in scrotal rejuvenation is likely to increase as men and their physicians become aware of both the conditions of the scrotum that may warrant rejuvenation and the potential treatments of the scrotum for these individuals.