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PubMed2003

Verrucous porokeratosis of Mibelli on the buttocks mimicking psoriasis.

The typical presentation of porokeratosis of Mibelli is of a solitary plaque with a prominent raised border cleaved by a central furrow. The central portion of the plaque is usually slightly atrophic. The plaques vary in size from a few millimeters to several centimeters in diameter and tend to be acrally distributed, though they can occur on any part of the body. We report an unusual case of verrucous porokeratosis of Mibelli, localized to the natal cleft, that mimicked psoriasis. This entity, though unusual, is not unique. Two similar cases of verrucous porokeratosis of Mibelli limited to the natal cleft region and resembling psoriasis have been reported in the British literature. Verrucous porokeratosis of Mibelli localized to the natal cleft appears to be a distinct clinical entity that can mimic psoriasis. Better recognition of this form of porokeratosis of Mibelli may result in earlier diagnosis and initiation of appropriate therapy.

Buttocks↗
PubMed1989

Deltoid versus buttock as preferred site of injection for hepatitis B vaccine.

Several factors concerning effectiveness of the hepatitis B virus (HBV) vaccination have been discovered: site of injection, indications for revaccination, testing for immunity, persistence of HBV antibody following vaccination, and age of recipient. The site may be important in provoking an appropriate antibody response. The deltoid is recommended rather than the gluteal. It is suggested that recipients of gluteal vaccinations receive revaccination in the deltoid. Revaccination is also recommended five years after the original series due to possible loss of antibody response. This is especially important to those with continued exposure to HBV such as medical personnel. However, caution is suggested as undetectable antibody appears to be an unreliable predictor of susceptibility to infection. It is also recommended that testing for immunity after vaccination be conducted only in those in whom a suboptimal response is expected, i.e., gluteal injection recipients and immunocompromised patients. Age of the recipient appears to be a major confounder influencing the duration of vaccine-induced immunity. The physician's consideration of these factors when administering the HBV vaccine should increase the overall effectiveness of immunization.

Arm↗