Clinical, Histological and Trichoscopic Correlations in Scalp Disorders

Trichoscopy is the term coined for the dermoscopic imaging of scalp and hair. This diagnostic technique, simple and noninvasive, can be used as a handy bedside tool for the diagnosis and follow-up of hair and scalp disorders. It allows the recognition of morphologic structures not visible by the naked eye and provides the clinician with a range of dermoscopic findings necessary for differential diagnosis. Trichoscopy observation can be broadly grouped as interfollicular patterns and follicular patterns. Recently, a third mixed class, called the follicular plus interfollicular pattern, has been introduced. Some of these features are specific to a certain scalp disease, while others can be found in many hair disorders. Although studies suggest that the use of trichoscopy can improve clinical accuracy, further investigation is needed. This review provides update information on the trichoscopic features of the most common scalp disorders, striving to show a histopathological and clinical correlation

Dermoscopy and methyl aminolevulinate: A study for detection and evaluation of field cancerization

Actinic keratosis (AK) is a keratinocyte intraepidermal neoplasia UV light – induced that frequently appears in sun-exposed areas of the skin. Although historically AK was de fi ned as “ precancerous ” , actually it is considered as the earliest stage of squamous cell carcinoma (SCC) in situ. Since AKs can progress into invasive SCC, their treatment isrecommended. AKsrarely developasa singlelesion;usually multiplelesions commonly affect anen- tire area of chronically actinic damaged skin. This has led to the concept of “ fi eld cancerization ” , an area chroni- cally sun-exposed that surrounds peripherally visible lesions, in which are individualized subclinical alterations. One of the main principles endpoint in the management of AKs is the evaluation and the treatment of fi eld cancerization. In this view, in order to detect and quantify fi eld cancerization, we employed a method based on the topical application of methyl aminolevulinate (MAL) and the detection of the fl uorescence emitted by its metabolite Protoporphyrin IX (PpIX); then, considering the extension and the intensity of measured fl uores- cence, we create a score of fi eld cancerization. The results show that patients underwent to daylight PDT had a reduction of total score, from T0 to T2. Whereas in the group untreated we observed a stability of total score or a slightly worse. So, the method and the score used allows to evaluate with a good approximation the dimension of fi eld cancerization and show the modi fi cation of it after treatment

Protection of Prisoners with Mental Health Disorders in Italy: Lights and Shadows after the Abolition of Judicial Psychiatric Hospitals

In Italy, a person suffering from a mental disorder who commits a crime will be given a custodial security order and serve the period of admission at a Residenza per la esecuzione delle misure di sicurezza (REMS) (Residence for the Execution of Security Measures, hereinafter "REMS"). These institutions have been established recently and though equipped with the necessary safety measures, the focus is on psychiatric therapy. Despite being present on a national scale, access is very limited in terms of capacity. Immediate remedial measures are needed, so much so that the European Court of Human Rights recently condemned Italy for this very reason. This article, through a review of the constitutive principles of these institutions, shows how they have very positive aspects such as the attention to necessary psychotherapy in order to protect the right to health and the real taking charge of the fragility of the subjects; however, it is seen how there are many negative aspects linked above all to the scarce availability of places in these structures. The article provides suggestions on a more comprehensive strategy for facilities for detainees with mental disorders

Italian Guidelines in diagnosis and treatment of alopecia areata

Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The Italian Study Group for Cutaneous Annexial Disease of the Italian Society of dermatology proposes these Italian guidelines for diagnosis and treatment of Alopecia Areata deeming useful for the daily management of the disease. This article summarizes evidence-based treatment associated with expert-based recommendations

La competencia pragmática en la adquisición del español como lengua extranjera. Análisis de la conversación en aprendices italófonos y sus implicaciones pedagógicas

La pragmática, esencial en la enseñanza de español como lengua extranjera (ELE), ha atraído la atención de destacados autores y aportaciones valiosas de investigadores. (Calvi, 1998; Fuentes Rodríguez, 2000; Escandell Vidal, 2006; Andorno, 2007; Landone, 2009). La disciplina, en efecto, permite a los aprendices perfeccionar su competencia comunicativa al estudiar y practicar estructuras lingüísticas utilizadas en situaciones reales. En el marco de este ámbito, la presente investigación persigue evaluar la presencia del componente pragmático en las producciones orales de dos grupos de estudiantes de español como segunda lengua, cuyo idioma materno es el italiano, a través de la incorporación en sus conversaciones de los marcadores discursivos. En la fase empírica del estudio, se ahondará en el cálculo de la frecuencia y en el uso que los aprendices italófonos hacen de los marcadores discursivos, con el fin de extraer un análisis contrastivo con un grupo de control de nativos españoles y verificar si las estrategias y los mecanismos discursivos se efectúan con los mismos recursos pragmáticos (prueba pretratamiento didáctico). En el proceso, consideraremos la L1 como una variable dependiente que, en el caso de la lengua italiana, podría afectar positivamente la producción de la L2, por cuestión de afinidad lingüística y sociopragmática, pero también negativamente, a la hora de enfrentarse a ciertos mecanismos pragmáticos subyacentes, cuya cercanía resultaría bastante engañosa. De igual manera, evaluaremos en qué medida los aprendices italófonos del español pueden perfeccionar su competencia pragmática a través de la enseñanza explícita en este campo y, por consiguiente, comprobar cómo varia la producción de los marcadores objeto de análisis tras un estímulo pedagógico activo (prueba postratamiento didáctico). Desde una perspectiva teórico-metodológica, el presente estudio adoptará el enfoque macrosintáctico propuesto por Fuentes Rodríguez (2013a, 2017a, 2019a, 2020), cuyos fundamentos se hallan en el marco conceptual de la Lingüística Pragmática (Fuentes Rodríguez, 2017 [2000]). Además, en cuanto a la recopilación y selección de datos, nuestra investigación se adscribe a la línea metodológica conocida como modelo cuasiexperimental con diseño de muestra separada pre y post test (Hedrick et al, 1993). Por lo tanto, a través de este enfoque, realizaremos un análisis tanto transversal como longitudinal, comparando los grupos de aprendices entre sí y con el grupo de control compuesto por hablantes nativos de español. En su conjunto, el esquema analítico de la tesis arrojará luz sobre el papel de la lengua materna y el nivel de competencia lingüística de la L2 de los aprendices italófonos participantes al estudio. Asimismo, se destacarán las evoluciones significativas en este aspecto durante la fase de comparación entre las pruebas realizadas antes y después del tratamiento didáctico. Al concluir la exhaustiva revisión de cada corpus, se presentarán reflexiones pedagógicas que servirán como fundamento para extraer conclusiones pertinentes a este estudio. Dichas conclusiones destacarán la imprescindible necesidad de considerar los aspectos pragmáticos inherentes a la lengua materna (L1) y las limitaciones derivadas presentes en la enseñanza de los marcadores discursivos en la lengua extranjera (L2)

Aquagenic keratoderma with no palmar involvement and no complete resolution after drying: an unusual clinical presentation

Aquagenic keratoderma (АK) is a rare benign skin disorder consisting in a transient reactive papulotranslucent acrokeratoderma, aquagenic wrinkling of the palms or aquagenic syringeal acrokeratoderma. A 9 years old Caucasian girl, born out of nonconsanguineous marriage, suffering from ADHD (Attention Deficit Hyperactivity Disorder), presented a hyper-wrinkling of all the ventral aspects of the distal phalanges and whitish-erythematous plaques in correspondence with the metacarpophalangeal joints after immersion in water (15°C for 15 seconds); after the skin drying (30 minutes), eroded erythematous plaques on the fingers persisted. Curiously, no palmar involvement was observed. No familiar history was noted, no actual use of medications was reported

Use of topical ephedrine and naphazoline in the treatment of a keratoacanthoma: two case reports.

Keratoacanthoma(KA) is a relatively common low-grade malignant keratinocytic neoplasm, usually involving sun exposed areas. Up to date the etiopathogenesis of KA is not completely understood, although it is assumed that the lesion is derived from the hair follicle and that several chemical and non-chemical factors(as chemical carcinogens, mineral oil, cigarettes, trauma and immunosuppres-sion) may be implicated [1,2]. KA presents three distinct stages, characterized in a rapid proliferative phase(6-8 weeks) [3,4], a phase of stop growing [5,6] and a third stage (or involution stage) where 50% of KA undergo to spontaneous resolution in 4–6 weeks, leaving an atrophic and hypopigmented scar [7]. The typical clinical specificity and natural course of the lesion, in some cases does not require a surgical treatment and histological examination, favoring a non-invasive treatment of the lesion

Vascular Psoriasis Area Severity Index: A dermoscopic standard technique for assessing severity psoriasis and therapeutic management

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Effects of Very Low Calorie Ketogenic Diet on the Orexinergic System, Visceral Adipose Tissue, and ROS Production

Background: Caloric restriction is a valid strategy to reduce the visceral adipose tissue (VAT) content in obese persons. Hypocretin-1 (orexin-A) is a neuropeptide synthesized in the lateral hypothalamus that strongly modulates food intake, thus influencing adipose tissue accumulation. Therapeutic diets in obesity treatment may combine the advantages of caloric restriction and dietary ketosis. The current study aimed to evaluate the effect of a very low calorie ketogenic diet (VLCKD) in a population of obese patients. Methods: Adiposity parameters and orexin-A serum profiling were quantified over an 8 week period. The effect of the VLCKD on reactive oxygen species (ROS) production and cell viability was evaluated, in vitro, by culturing Hep-G2 cells in the presence of VLCKD sera. Results: Dietary intervention induced significant effects on body weight, adiposity, and blood chemistry parameters. Moreover, a selective reduction in VAT was measured by dual-energy X-ray absorptiometry. Orexin-A levels significantly increased after dietary treatment. Hep-G2 cell viability was not affected after 24, 48, and 72 h incubation with patients’ sera, before and after the VLCKD. In the same model system, ROS production was not significantly influenced by dietary treatment. Conclusion: The VLCKD exerts a positive effect on VAT decrease, ameliorating adiposity and blood chemistry parameters. Furthermore, short-term mild dietary ketosis does not appear to have a cytotoxic effect, nor does it represent a factor capable of increasing oxidative stress. Finally, to the best of our knowledge, this is the first study that shows an effect of the VLCKD upon the orexinergic system, supporting the usefulness of such a therapeutic intervention in promoting obesity reduction in the individual burden of this disease