Cover
About the Editor – Prof. Sunit K. Singh
Preface
1 Mucosal Immunity in Sexually Transmitted Infections
1. 1.1 Introduction
2. 1.2 Innate Immunity in the Genital Tract
3. 1.3 Immunoglobulins in Secretions of the Genital Tract
4. 1.4 Cells of the Mucosal Immune System of the Genital Tract
5. 1.5 Induction of Immune Responses in the Genital Tract
6. 1.6 Concluding Remarks
7. References
2 The Role of Circumcision in Preventing Sexually Transmitted Infections
1. 2.1 Introduction
2. 2.2 Biological Mechanisms
3. 2.3 Methods of Circumcision
4. 2.4 Complications
5. 2.5 Role of MC in Transmission of HIV
6. 2.6 Human Papilloma Virus (HPV)
7. 2.7 Nonulcerative STIs
8. 2.8 Ulcerative STIs/Genital Ulcer Disease (GUD)
9. 2.9 Use of Male Circumcision as a Public Health Measure
10. 2.10 Female Genital Mutilation (FGM)
11. References
3 Effect of Probiotics on Reproductive Health
1. 3.1 Introduction
2. 3.2 Definition of Probiotics
3. 3.3 Vaginal Microflora (Microbiota)
4. 3.4 Applications of Probiotics in Vaginal and Reproductive Health
5. 3.5 Conclusions
6. References
4 Human Immunodeficiency Virus (HIV) Infection
1. 4.1 Introduction
2. 4.2 HIV Structure/Genome
3. 4.3 Routes of Transmission
4. 4.4 Host Factors Influencing HIV Infectivity in Sexual Transmission
5. 4.5 Viral Factors Influencing HIV Infectivity in Sexual Transmission
6. 4.6 Mechanism of Pathogenesis
7. 4.7 Diagnosis of HIV Infections
8. 4.8 Therapeutics
9. 4.9 Conclusion
10. References
5 Genital Herpes
1. 5.1 Introduction
2. 5.2 Pathogen
3. 5.3 Epidemiology
4. 5.4 Pathogenesis and Immunity
5. 5.5 Clinical Features
6. 5.6 Diagnosis
7. 5.7 Treatment
8. 5.8 Prevention and Control
9. 5.9 Conclusion
10. References
6 Molluscum Contagiosum
1. 6.1 Introduction
2. 6.2 Epidemiology
3. 6.3 Molecular Pathogenesis
4. 6.4 Diagnosis
5. 6.5 Clinical Features
6. 6.6 Mode of Spread of Infections
7. 6.7 Treatment
8. 6.8 Conclusion
9. References
7 Genital Warts
1. 7.1 Introduction
2. 7.2 Human Papillomavirus
3. 7.3 Epidemiology
4. 7.4 Risk and Protective Factors
5. 7.5 Clinical Features
6. 7.6 Diagnostics
7. 7.7 Differential Diagnosis
8. 7.8 Treatment
9. 7.9 Specific Groups
10. 7.10 HPV Vaccination
11. References
8 Chlamydia Trachomatis Urogenital Infections: Epidemiology, Clinical Presentations, and Pathogenesis
1. 8.1 Introduction
2. 8.2 Epidemiology
3. 8.3 Chlamydial Biology
4. 8.4 Clinical Features
5. 8.5 Pathogenesis of Chlamydial Infections
6. 8.6 Diagnosis and Treatment
7. 8.7 Prevention and Control
8. 8.8 Conclusion
9. References
9 Donovanosis
1. 9.1 Introduction
2. 9.2 Epidemiology
3. 9.3 Pathology
4. 9.4 Incubation Period
5. 9.5 Clinical Pictures
6. 9.6 Sites of Involvement
7. 9.7 Complications and Sequelae
8. 9.8 Diagnosis
9. 9.9 Differential Diagnosis
10. 9.10 Treatment
11. 9.11 Prevention and Control
12. 9.12 Disease Control and Prevention
13. References
10 Gonorrhea
1. 10.1 Introduction
2. 10.2 Pathogen
3. 10.3 Pathogenesis and Immunity
4. 10.4 Epidemiology
5. 10.5 Clinical Features
6. 10.6 Diagnosis
7. 10.7 Treatment
8. 10.8 Prevention and Control
9. 10.9 Conclusion
10. References
11 Sexually Transmitted Treponematoses
1. 11.1 Introduction
2. 11.2 Genetics of TPA and TEN Strains
3. 11.3 Virulence Factors of Syphilis and Bejel
4. 11.4 Diagnostics of Syphilis and Bejel
5. 11.5 Treatment of Syphilis and Bejel
6. 11.6 Molecular Typing of Syphilis and Bejel Treponemes
7. 11.7 Vaccine Development for Syphilis and Bejel
8. References
12 Genital Mycoplasmas
1. 12.1 Introduction
2. 12.2 Biology
3. 12.3 Pathogenesis
4. 12.4 Epidemiology
5. 12.5 Clinical Presentation
6. 12.6 Laboratory Diagnosis
7. 12.7 Treatment
8. 12.8 Prevention and Control
9. References
13 Bacterial Vaginosis
1. 13.1 Introduction
2. 13.2 Implication of G. vaginalis in Bacterial Vaginosis
3. 13.3 Epidemiology and Risk Factors
4. 13.4 Pathogenesis and Immunity
5. 13.5 Clinical Features
6. 13.6 Diagnosis
7. 13.7 Treatment
8. 13.8 Conclusions
9. References
14 Chancroid
1. 14.1 Introduction
2. 14.2 Epidemiology of Chancroid and H. ducreyi
3. 14.3 Clinical Features
4. 14.4 The Pathogen
5. 14.5 Pathogenesis and Immunity
6. 14.6 Diagnosis, Treatment, and Prevention
7. 14.7 Chronic Limb Ulcers Caused by H. ducreyi
8. 14.8 Conclusions
9. References
15 Vulvovaginal Candidosis
1. 15.1 Introduction
2. 15.2 Etiology
3. 15.3 Epidemiology
4. 15.4 Pathogenesis and Immunity
5. 15.5 Symptoms and Signs
6. 15.6 Diagnosis and Differential Diagnosis
7. 15.7 Treatment
8. References
16 Tinea Cruris
1. 16.1 Introduction
2. 16.2 Etiology and Epidemiology
3. 16.3 Tinea Cruris as a Sexually Transmitted Infection (STI)
4. 16.4 Transmission
5. 16.5 Pathogenesis
6. 16.6 Differential Diagnoses
7. 16.7 Laboratory Diagnosis
8. 16.8 Treatment of Tinea Cruris and Genitalis
9. 16.9 Conclusion
10. Acknowledgments
11. References
17 Trichomonas Vaginalis
1. 17.1 Introduction
2. 17.2 Epidemiology of T. vaginalis
3. 17.3 HIV and Trichomonas
4. 17.4 Biology and Pathogenesis of T. vaginalis
5. 17.5 Clinical Features of T. vaginalis Infection
6. 17.6 Diagnosis of T. vaginalis
7. 17.7 Treatment of T. vaginalis
8. 17.8 Conclusion
9. References
18 Scabies
1. 18.1 Introduction
2. 18.2 Epidemiology
3. 18.3 Etiopathogenesis
4. 18.4 Clinical Features
5. 18.5 Diagnosis
6. 18.6 Treatment
7. 18.7 Prevention and Control
8. 18.8 Conclusion
9. References
Index
End User License Agreement

List of Tables

Chapter 01
1. Table 1.1 Some Innate Defense Factors Found in the Human Genital Tract.
2. Table 1.2 Levels, Properties, and Biological Activities of Ig in the Genital Tract.
Chapter 03
1. Table 3.1 Evolution of the description of probiotics.
2. Table 3.2 Vaginal microflora during reproductive age (Antonio et al. 1999; Burton and Reid 2002; Vasquez et al. 2002; Burton et al. 2003; Pabich et al. 2003; Strus et al. 2004; Kochan 2011; Huang et al. 2014a and 2014b).
Chapter 04
1. Table 4.1 Available anti‐HIV drugs.
Chapter 05
1. Table 5.1 Interpretation of laboratory findings for diagnosis of HSV infection in correlation with symptoms of genital herpes.
2. Table 5.2 Antiviral treatment of genital herpes.
Chapter 06
1. Table 6.1 The treatment options of Molluscum contagiosum.
Chapter 07
1. Table 7.1 Differential diagnosis of genital warts.
2. Table 7.2 Recommended regimens for genital warts.
Chapter 09
1. Table 9.1 Lobo Jardim’s clinical classification of Donovanosis (Jardim et al. 2006).
Chapter 10
1. Table 10.1 Sensibility and specificity of several tests for Neisseria gonorrhoeae according to sample type.
2. Table 10.2 Clinical samples for the diagnosis of gonorrhea.
3. Table 10.3 Characteristics of Gram‐negative, oxidase‐positive Neisseria, and related species of human origin.
4. Table 10.4 Summary of commercially available FDA‐approved gonorrhea NAAT platforms.
5. Table 10.5 Treatment Guidelines of Different Health Associations Worldwide.
Chapter 12
1. Table 12.1 Genital mycoplasmas ‐ date of first description and pathogenicity.
2. Table 12.2 Biology features of pathogenic genital mycoplasmas.
3. Table 12.3 General trends of genital mycoplasmas drug susceptibility.
Chapter 13
1. Table 13.1 Scoring system for Gram‐stained vaginal smears^a (Nugent et al. 1991).
2. Table 13.2 Potential techniques for BV diagnosis.
Chapter 14
1. Table 14.1 Virulence factors required for pathogenesis of Haemophilus ducreyi in human volunteers.
Chapter 15
1. Table 15.1 Prevalence of symptomatic, acute episodic, and recurrent Candida vulvovaginitis in pregnant and nonpregnant women.
2. Table 15.2 Prevalence of vaginal non‐albicans species in women with vulvovaginitis.
3. Table 15.3 Known genetic abnormalities influencing occurrence and severity of RVVC.
4. Table 15.4 Overview of frequently used medication for Candida vaginitis and RVVC.

List of Illustrations

Chapter 03
1. Figure 3.1 Bifidobacterium longum Gram‐stained microscopic specimen (magnification 1000×).
2. Figure 3.2 Significant differences in drug sensitivity within the same species. Shown here are two Lactobacillus rhamnosus strains tested using novel cephalosporin‐ceftaroline Etest and disc‐diffusion test: L. rhamnosus KL53A (sensitive, shown on the left) vs. L. rhamnosus GG (reduced susceptibility, on the right).
3. Figure 3.3 Lactobacillus acidophilus Gram‐stained microscopic specimen (magnification 1000×).
Chapter 04
1. Figure 4.1 Structure and genomic organization of HIV.
2. Figure 4.2 HIV life cycle.
Chapter 06
1. Figure 6.1 (a) Characteristic umbilicated crater with a white core, and its pearl‐like shiny coloring papules of molluscum contagiosum on face (b) Umbilicated papules on neck (c) Umbilicated, skin colored papules on groins
2. Figure 6.2 Central pore or umbilication in association with polylobular white to yellowish shiny clods in dermoscopic examination (3Gen, Dermlite 4)
3. Figure 6.3 Hypertrophic, hyperplastic epidermis, and molluscum bodies within the keratinocytes and a central crater (H&E,x4)
Chapter 07
1. Figure 7.1 Smooth papules genital warts.
2. Figure 7.2 Cauliflower‐like genital warts.
3. Figure 7.3 Keratotic genital warts.
4. Figure 7.4 Plaque type genital warts.
Chapter 09
1. Figure 9.1 Granulomatous infiltrate compound by histiocytes and plasma cells (Hematoxilin & Eosin, 400×) (personal collection).
2. Figure 9.2 Donovan bodies (GIEMSA STAIN) (personal collection).
3. Figure 9.3 Initial Lesion (personal collection).
4. Figure 9.4 Ulceration with hypertrophic borders (personal collection).
5. Figure 9.5 Ulceration with flat borders (personal collection).
6. Figure 9.6 Ulcerovegetating (personal collection).
7. Figure 9.7 Vegetating (personal collection).
8. Figure 9.8 Elephantiasis (personal collection).
9. Figure 9.9 Extragenital (personal collection).
10. Figure 9.10 Donovan bodies inside mononuclear cells (personal collection).
Chapter 10
1. Figure 10.1 Gram stain of Neisseria gonorrhoeae in urethral sample.
2. Figure 10.2 Typical colonies of Neisseria gonorrhoeae in modified Thayer Martin culture medium.
Chapter 11
1. Figure 11.1 Whole genome alignment of uncultivable pathogenic treponemes. The tree was constructed using MEGA7 software (Kumar et al. 2016). The Neighbor‐Joining method, using the Tamura‐Nei genetic distance model and 1000 bootstrap replicates, was used. The bar scale represents 0.0002 substitutions per site and the numbers above or below the branches show bootstrap support. Only 6 out of 24 completely sequenced TPA isolates (marked as PT_SIF) from a study by Pinto et al. (2016) are shown due to the considerable similarity among analyzed genomes (differing in less than 20 single nucleotide variant (SNVs)). TPA strains, TPE strains, and TEN strains are shown in red, green, and blue color, respectively. Note the clustering of TPA strains into either Nichols‐like or SS14‐like group of strains named according to sequence relatedness to reference strain TPA Nichols or TPA SS14.
2. Figure 11.2 The worldwide prevalence of macrolide resistant TPA strains. Higher intensity of color means a higher prevalence of macrolide resistant strains. Only the most recent data from geographic regions with multiple prevalence studies are shown. For countries shown in gray, data about the prevalence of macrolide resistant strains are not known.
3. Figure 11.3 Worldwide distribution of Nichols‐like and SS14‐like clinical isolates. The assignment of strains to either the Nichols‐like of SS14‐like group is based on the sequence analysis of an 83 bp‐long fragment of TP0548 (coordinates 593 399–593 481 according to whole genome sequence of TPA Nichols) used in both enhanced CDC and sequencing‐based typing schemes. Please note the worldwide predominance of SS14‐like strains and the differences in distribution of Nichols‐like and SS14‐like strains.
Chapter 12
1. Figure 12.1 Colonies of Mycoplasma hominis and Ureaplasma spp. growing on A8 agar after 72 hours of incubation as they appear under 100× magnification. Colony of M. hominis demonstrate a characteristic fried‐egg appearance, while colonies of Ureaplasma spp. are twice smaller and uniformly blurred.
2. Figure 12.2 Gel image of electropherogram of a single and dual infections detected by multiplex PCR test (Seeplex STD6, Seegene) which detect Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomaons vaginalis, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum: (a) (1)X1‐ladder; (2) A1–410 bp/M. genitalium positive sample; (3)A2–130 bp/U. urealyticum positive sample, (4)A3–502 bp/M. hominis positive sample; (5)A4 ‐positive control = 981 bp/internal PCR control, 647 bp/T. vaginalis, 502 bp/M. hominis, 410 bp/M. genitalium, 315 bp/C. trachomatis, 214 bp/N. gonorrhoeae, 130 bp/U. urealyticum; (6)A5‐ negative control (a) (1)X1‐ladder; (2) A1–502 bp/M. hominis and 130 bp/U. urealyticum positive sample; (3)A2–315 bp/C. trachomatis and 130 bp/U. urealyticum positive sample; (4)A3 ‐positive control = 981 bp/internal PCR control, 647 bp/T. vaginalis, 502 bp/M. hominis, 410 bp/M. genitalium, 315 bp/C. trachomatis, 214 bp/N. gonorrhoeae, 130 bp/U. urealyticum; (5)A4‐ negative control.
Chapter 14
1. Figure 14.1 Clinical case of penile chancroid with multiple ulcerative lesions.
Chapter 15
1. Figure 15.1 Different morphologies of Candida. Panel A: sperm heads without tail (black arrows), not to be confused with Candida blastospores, normal lactobacillary flora (grade 1), no inflammation; Panel B: blastospores (1500× magnification) with snowman sign (white arrow); Panel C: psseudohyphae, disturbed microscora (lactobacillary grade 3 with inflammatory cells – aerobic vaginitis); Panel D: mycelium or hyphae, discturbed microflora lactobacilllary grade 3).
2. Figure 15.2 Clinical appearance of Candida vulvitis. Panel A: typical fissures at 6 o’clock at the perineum (two arrows); Panel B. edema, lichenoid skin (ellips) and fissure at 12 o’clock (black arrow); Panel C. Vaginal discharge in patient with acute vulvovaginal candidosis.
3. Figure 15.3 Schematic flow chart of individualized degressive dose regimen with fluconazole for recurrent vulvovaginal candidosis (Donders et al., 2008).
4. Figure 15.4 Flow chart of approach of a patient with recurrent vuvlovaginal candidosis (Donders et al., 2010).
Chapter 16
1. Figure 16.1 Annular scaly plaques of tinea cruris et corporis without any genital involvement.
2. Figure 16.2 Severe tinea cruris et corporis with tinea genitalis (involvement of penile shaft).
3. Figure 16.3 Isolated involvement of penile shaft in tinea genitalis, a rare occurrence.
4. Figure 16.4 Tinea corporis et cruris in a young girl.
Chapter 17
1. Figure 17.1 Age‐specific prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. The age‐specific prevalence for C. trachomatis (CT), N. gonorrhoeae (GC), and T. vaginalis (TV) are shown from a multisite study of >1900 women. Gonorrhea rates are slightly higher in young women while chlamydia rates show the typical pattern of a definite peak for women less than 30. In the same women, trichomonas infection peaked in 35–50 year olds.
2. Figure 17.2 Trichomonas vaginalis from in vitro culture. Trichomonads stained with Giemsa stain (from www.cdc.gov). Arrows show the flagella and asymmetrically located undulating membrane.
Chapter 18
1. Figure 18.1 Scabies: burrow (circle).
2. Figure 18.2 Scabies: papules on the wrist.
3. Figure 18.3 Scabies: multiple papules on the trunk in a newborn.
4. Figure 18.4 Scabies: papules, excoriations, and crusts.
5. Figure 18.5 Scabies: several excoriated papules on the abdomen.
6. Figure 18.6 Scabies: impetiginized and crusted lesions.
7. Figure 18.7 Nodular scabies: solitary lesion on the penis in a child.
8. Figure 18.8 Crusted scabies: hyperkeratotic lesions on the palm.
9. Figure 18.9 Scabies: dermatoscopy at ×10 magnification showing the presence of a burrow. At one extremity a pigmented brown triangular structure (corresponding to the anterior part of Sarcoptes scabiei) is evident (arrowhead).
10. Figure 18.10 Crusted scabies: dermatoscopy at ×10 magnification showing the presence of a multiple burrows.
11. Figure 18.11 Scabies: high magnification dermatoscopy at ×500 magnification showing the mite. The pigmented head and anterior legs are evident (arrowhead).

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Library of Congress Cataloging‐in‐Publication Data

Names: Singh, Sunit K., editor.
Title: Diagnostics to pathogenomics of sexually transmitted infections /edited by, Sunit K. Singh.
Description: Hoboken, NJ : Wiley Blackwell, 2018. | Includes bibliographical references and index. |
Identifiers: LCCN 2018024559 (print) | LCCN 2018024972 (ebook) | ISBN9781119380900 (Adobe PDF) | ISBN 9781119380955 (ePub) | ISBN 9781119380849 (hardcover)
Subjects: | MESH: Sexually Transmitted Diseases
Classification: LCC RC200 (ebook) | LCC RC200 (print) | NLM WC 140 | DDC616.95/1–dc23
LC record available at https://lccn.loc.gov/2018024559

Cover Design: Wiley
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Contributors

Kourosh Afshar
Division of Pediatric Urology
Department of Urologic Sciences
University of British Columbia
Vancouver, British Columbia, Canada

Charles W. Armitage
Institute of Health and Biomedical Innovation & School of Biomedical Sciences
Queensland University of Technology
Brisbane, Australia

Margaret E. Bauer
Department of Microbiology and Immunology
Indiana University School of Medicine
Indianapolis, IN, USA

Kenneth W. Beagley
Institute of Health and Biomedical Innovation & School of Biomedical Sciences
Queensland University of Technology
Brisbane, Australia

Gert Bellen
Femicare vzw
Tienen, Belgium

Anuradha Bishnoi
Department of Dermatology and Venereology
Postgraduate Institute of Medical Education & Research
Chandigarh, India

Alison J. Carey
Institute of Health and Biomedical Innovation & School of Biomedical Sciences
Queensland University of Technology
Brisbane, Australia

Nuno Cerca
Centre of Biological Engineering LIBRO ‐ Laboratory of Research in Biofilms Rosário Oliveira
University of Minho
Braga, Portugal

Sarita Martins De Carvalho Bezerra
Ceder‐Hospital Santo Amaro
Recife, Pernambuco, Brazil

Gilbert G.G. Donders
Femicare vzw
Tienen, Belgium
and
Department of OB/Gyn
Antwerp University
Antwerp, Belgium
and
Regional Hospital Hart
Tienen, Belgium

Giorgia Giuffrida
Dermatology Clinic
University of Catania
Catania, Italy

Sivtrigaile Grinceviciene
Femicare vzw
Tienen, Belgium
and
Department of Biothermodynamics and Drug DesignInstitute of BiotechnologyVilnius University
Vilnius, Lithuania

Piotr B. Heczko
Department of Bacteriology
Microbial Ecology and Parasitology
Jagiellonian University Medical College
Cracow, Poland

Danica K. Hickey
Institute of Health and Biomedical Innovation & School of Biomedical Sciences
Queensland University of Technology
Brisbane, Australia

Diane M. Janowicz
Department of Medicine
Indiana University School of Medicine
Indianapolis, IN, USA

Ayse Serap Karadag
Department of Dermatology
Medical Faculty Goztepe, Training and Research Hospital
Istanbul Medeniyet University
Istanbul, Turkey

Behnam Kazemi
Division of Pediatric Urology, Department of Urologic Sciences
University of British Columbia
Vancouver, British Columbia, Canada

Piotr Kochan
Department of Microbiology
Jagiellonian University Medical College
Cracow, Poland

Francesco Lacarrubba
Dermatology Clinic
University of Catania
Catania, Italy

Suncanica Ljubin‐Sternak
Clinical Microbiology Department
Teaching Institute of Public Health “Dr Andrija Stampar”, & Medical Microbiology Department
School of Medicine
University of Zagreb
Zagreb, Croatia

Marcio Martins Lobo Jardim
Ceder‐Hospital Santo Amaro
Recife, Pernambuco, Brazil

Andrew E. MacNeily
Division of Pediatric Urology
Department of Urologic Sciences
University of British Columbia
Vancouver, British ColumbiaCanada

Rahul Mahajan
Department of Dermatology and Venereology
Postgraduate Institute of Medical Education & Research
Chandigarh, India

Jiri Mestecky
Department of Microbiology
University of Alabama at Birmingham
Birmingham, Al, USA
and
Institute of Immunology and Microbiology
First School of Medicine
Charles University
Prague, Czech Republic

Giuseppe Micali
Dermatology Clinic
University of Catania
Catania, Italy

Lenka Mikalová
Department of Biology
Faculty of Medicine
Masaryk University
Brno, Czech Republic

María Teresa Pérez‐Gracia
Área de Microbiología
Departamento de Farmacia
Instituto de Ciencias Biomédicas
Facultad de Ciencias de la Salud
Universidad CEU‐Cardenal Herrera
Valencia, Spain

Filip Rob
Dermatovenereology Department
Second Medical Faculty of Charles University
Na Bulovce Hospital
Prague, Czech Republic

Aliona Rosca
Centre of Biological Engineering, LIBRO ‐ Laboratory of Research in Biofilms Rosário Oliveira
University of Minho
Braga, Portugal

Katerina S. Ruban
Femicare vzw
Tienen, Belgium

Michael W. Russell
Department of Microbiology and Immunology
University of Buffalo
Buffalo, NY, USA

Andreas Sauerbrei
Section Experimental Virology
Institute of Medical Microbiology
Jena University Hospital, Friedrich‐Schiller University of Jena
Jena, Germany

Santosh Kumar Singh
Molecular Biology UnitFaculty of Medicine
Institute of Medical Sciences
Banaras Hindu University
Varanasi, Uttar Pradesh, India

Sunit K. Singh
Molecular Biology UnitFaculty of Medicine
Institute of Medical Sciences
Banaras Hindu University
Varanasi, Uttar Pradesh, India

David Šmajs
Department of Biology
Faculty of Medicine
Masaryk University
Brno, Czech Republic

Magdalena Strus
Department of Bacteriology
Microbial Ecology and Parasitology
Jagiellonian University Medical College
Cracow, Poland

Beatriz Suay‐García
Área de Microbiología
Departamento de Farmacia
Instituto de Ciencias Biomédicas
Facultad de Ciencias de la Salud
Universidad CEU‐Cardenal Herrera
Valencia, Spain.

Juliana Uchiyama
Ceder‐Hospital Santo Amaro
Recife, Pernambuco, Brazil

Tugba Kevser Uzuncakmak
Department of Dermatology
Medical Faculty Goztepe
Training and Research Hospital
Istanbul Medeniyet University
Istanbul, Turkey

Barbara Van Der Pol
School of Medicine
University of Alabama
Birmingham, AL, USA