Essential of Hair Care Cosmetics

Nowadays, hair care and style play a very important role in people's physical aspect and self-perception. Hair cosmetics can be distinguished into two main categories: cosmetics with temporary effect on the hair, for example shampoos, conditioners, sprays, and temporary colors; and cosmetics with permanent effect on the hair, such as permanent waves, relaxers, bleaches and permanent colors. These cosmetic procedures may induce hair abnormalities. We provide an overview on the most important characteristics of these procedures, analyzing components and effects on the hair. Finally, we evaluated new camouflage techniques and tattoo scalp

Application and comparison between non-invasive and invasive methods in the study of skin annexes diseases

Introduzione Lo scopo dello studio è valutare l’accuratezza diagnostica delle metodiche strumentali non invasive, in particolare dermoscopia, tomografia a coerenza ottica (OCT ) e microscopia confocale (RCM), nelle patologie degli annessi cutanei, confrontate con le metodiche invasive (biopsia ed exeresi chirurgica). Materiali e metodi È stato effettuato uno studio prospettico osservazionale in pazienti afferenti all’ambulatorio di Malattie degli Annessi Cutanei, dell’U.O. di Dermatologia dell’Azienda Ospedaliero - Universitaria di Bologna IRCCS Policlinico di Sant’Orsola, Dipartimento di Medicina Specialistica Diagnostica e Sperimentale (DIMES) dell’Università di Bologna, della durata di tre anni. Le metodiche di OCT e RCM sono state effettuate c/o il Policlinico di Modena, U.O. Dermatologia. Le patologie incluse comprendono malattie dei capelli e malattie ungueali. La prima parte dello studio si è focalizzata sullo studio delle metodiche non invasive, la seconda parte si è basata sulla conferma istologica del sospetto diagnostico inziale. Nella terza parte dello studio si è effettuato un confronto tra le diverse metodiche e una valutazione dell’accuratezza diagnostica delle stesse nelle malattie dei capelli e delle unghie. Risultati Sono stati valutati 231 pazienti (135 con diagnosi di malattie dei capelli e del cuoio capelluto; 96 con malattie delle unghie). In specifico, siamo riusciti a stabilire una corrispondenza tra i parametri tricoscopici, istologici e RCM per l’alopecia fibrosante frontale, l’alopecia areata incognita, la tinea capitis e il lichen simplex cronico. Nell’ambito delle malattie delle unghie, abbiamo valutato le correlazioni tra onicoscopia ed OCT per il lichen planus ungueale, la psoriasi ungueale, l’onicomicosi e il tumore glomico. Conclusioni Riteniamo lo studio molto utile, in quanto reputiamo che una conoscenza ancora più approfondita degli strumenti non invasivi per la diagnosi precoce di malattie degli annessi cutanei sia importante a diversi livelli, come ad esempio sui tempi di diagnosi e sulla riduzione dei costi di gestione.Introduction The purpose of the study is to evaluate the diagnostic accuracy of non-invasive instrumental methods, in particular dermoscopy, optical coherence tomography (OCT) and confocal microscopy (RCM), in the skin appendages disorders, compared with invasive methods (biopsy and surgical excision). Materials and methods A prospective observational study was performed in patients belonging to the Outpatient Department of Skin Annexes Diseases, of the Dermatology Unit of the Hospital - University of Bologna IRCCS Policlinico di Sant’Orsola, Department of Specialized Diagnostic and Experimental Medicine (DIMES) of the University of Bologna, lasting three years. The OCT and RCM methods were carried out at the Policlinico di Modena, Dermatology Unit. Evaluated diseases included hair diseases and nail diseases. The first part of the study focused on the study of non-invasive methods, the second part was based on the histological confirmation of the initial diagnostic suspicion. In the third part of the study, a comparison was made between the different methods and an evaluation of their diagnostic accuracy in hair and nail diseases. Results 231 patients were evaluated (135 diagnosed with hair and scalp diseases; 96 with nail diseases). Specifically, we were able to establish a correspondence between the trichoscopic, histological and RCM parameters for frontal fibrosing alopecia, alopecia areata incognita, tinea capitis and chronic lichen simplex. In nail diseases, we evaluated the correlations between onychoscopy and OCT for nail lichen planus, nail psoriasis, onychomycosis and glomus tumor. Conclusions We believe that the study is very useful, as we believe that an even deeper knowledge of non-invasive tools for the early diagnosis of skin annexes diseases is important at various levels, such as for example on diagnosis times and reduction of management costs

Diffuse Hair Loss in a Young Female

We present the case of a 21 year-old woman who came to our attention complaining an acute and diffuse hair loss, lasting from about 5 months. She also observed an important hair thinning. The patient was healthy and denied events like psychological stress, significant fever or fast weight loss in the previous months. She had no nutritional deficiency or thyroid disorders. The personal history revealed polycystic ovary syndrome, with normal hormones levels. Her familiar history was positive for male androgenetic alopecia. Clinical examination of the scalp revealed moderate hair density (Figure 1). Eyebrows, eyelashes and body hair were normal, as well as nails

Efficacious and safe management of thick scales, redness and flaky scalp condition using a specific shampoo containing urea, glycolic acid, salicylic acid, icthyol pale and laureth 9

Dandruff is a common condition, generally due to seborrheic dermatitis (SD) and occasionally to scalp psoriasis (SP), which is characterized by accumulation of scales, oily, red and flaky scalp, often accompanied by itch. The aim of our study was to evaluate the cleansing efficacy and tolerability of a new shampoo (Psorisdin Shampoo®) containing urea, glycolic acid, salicylic acid, ichthyol pale and laureth 9 compared to a nonspecific shampoo. A total of 10 subjects (4 males and 6 females, 18–60 years) with mild–moderate scalp inflammation with redness, itching and flaking, due to SP and/or SD, were included in this open clinical study. The treatment efficacy was assessed by comparison of global photography and trichoscopy pictures, evaluating the presence of scales and erythema on the scalp, the number and morphology of capillaries and verifying disease evolution, severity of symptoms and presence of scalp irritation/itch. The use of this medicated shampoo resulted in an important improvement of patient's scalp and hair clinical appearance and was well tolerated, with disappearance of scalp irritation and itching in almost all patients, showing higher cleansing and soothing property than a nonspecific shampoo. The effect of the tested shampoo was maintained over time, even after 5 days since the last wash

Clinical and Instrumental Objective Evidence of the Efficacy of a New Water-Based Nail-Strengthening Solution Containing Pistacia lentiscus and Hyaluronic Acid Applied for Up to 6 Months to Improve the Appearance of Weak, Brittle Nails

Introduction: Brittle nails are fragile or split nails; they affect 20% of the population and may be primary or secondary to different conditions. The aim of our studies was to evaluate the efficacy and tolerability of a new water-based nail-strengthening treatment containing hyaluronic acid and Pistacia lentiscus with daily application for a period of 1-3 months for one study (n = 30) and up to 6 months for a second study (n = 30). Methods: In total, we enrolled 60 patients of both sexes with brittle and weak nails due to primary or secondary causes and evaluated the efficacy of this new product using subjective and objective methods: clinical evaluation, assessment of photographs, onychoscopy evaluation, investigator and patient global assessment, dynamic optical coherence tomography (D-OCT) and reflectance confocal microscopy (RCM). Results: Studies subjects presented a statistically significant improvement in global assessment scale (GAS) scores at 14 days (GAS = 1.7 ± 0.6), 1 month (GAS = 1.4 ± 0.7) and at 3 months (GAS = 1±0.7) versus the GAS score obtained before treatment (1.9 ± 0.5) (p < 0.0001). From the Italian study at 6 months (n = 30) 76% of the patients had an improvement in their nail appearance. Reduction in nail plate roughness with improved nail resistance and decreased distal breakage were the most evident benefits, demonstrated on clinical and instrumental evaluations. No side effects were reported. All patients reported an improvement in nail appearance after using the product for 1 month, 3 months and 6 months, and had a positive opinion on the product. Conclusions: This new product is an effective, safe, and easy-to-use option for topical treatment of brittle nails and primary nail fragility and an adjuvant therapy in secondary nail fragility. Moreover, its ease of application and cosmetic qualities allow good compliance

An open clinical investigation on clinical dermatoscopy, OCT and RCM visible effects of application of a new topical product for 6 months on brittle nails and weak nails with rough surface and/or tendency to break

Introduction & Objectives Nail brittleness is a common complaint characterized by weak nails with rough surface and/or tendency to split, flake and crumble. This nail alteration can be a consequence of factors that alter the nail plate production or factors that damage the nail plate, such as cosmetics (permanent and non-permanent nail lacquers), psoriasis, lichen planus, ageing, chemotherapy, other drugs and anaemia. The aim of our study was to evaluate the effectiveness, tolerability and patient’s compliance of a new water-soluble nail lacquer with silicon and keratin synthesis booster product for brittle and weak nails. Material & Methods 30 patients of both sexes, aged >18 years, affected by nail brittleness were prescribed a new topical therapy to be applied on the affected nails once a day for 6 months. The new product is dispensed by a pencil unit with a brush and has to be applied on the entire edge of the nail, cuticle included. Periodic evaluation of treatment efficacy was performed by standardized photography and dry video-dermoscopy of the target nail at baseline (V1), after 15 days (V2), 1 month (V3), 3 months (V4) and 6 months (V5). The treatment efficacy was evaluated by the experimentator through Global and Trichoscopy Assessment Scale and by patients through a patient global assessment and a specify questionnaire. 10 patients also underwent to Optical Coherence Tomography (OCT) in order to have a further objective parameter of efficacy evaluation. Results All patients concluded the study, with marked improvement of nail weakness and appearance. No side effects were recorded. All patients judged the treatment easy to apply and effective. Conclusions This new water-soluble nail lacquer with silicon and keratin synthesis booster is an effective and safe option for the treatment of nail brittleness and damages

The Histopathologic Evaluation of Diagnostic Procedures in Nail Melanoma

Introduction: The diagnostic delay in nail melanoma (NM) has been repeatedly emphasized. It may be related to both clinical misinterpretations and to errors in the bioptic procedure. Objectives: To assess the efficacy of histopathologic examination in different diagnostic biopsies in NM. Methods: We retrospectively investigated the diagnostic procedures and histopathologic specimens referred to the Laboratory of Dermatopathology for the clinical suspicion of NM from 2006 to January 2016. Results: Eighty-six nail histopathologic specimens were analysed consisting in 60 longitudinal, 23 punch and 3 tangential biopsies. A diagnosis of NM was performed in 20 cases, benign melanocytic activation in 51 cases and melanocytic nevi in 15 patients. Longitudinal and tangential biopsy were diagnostic in all cases, regardless of the clinical suspicion. Nail matrix punch biopsy instead was not diagnostic in most of the cases (13/23 specimens). Conclusions:  In the presence of an NM clinical suspicion, longitudinal biopsy is recommended (lateral or median) because it provides exhaustive information on the characteristics of melanocytes’ morphology and distribution in all the components of the nail unit. Tangential biopsy, recently encouraged by expert authors due to the optimal surgical outcome, in our experience gives incomplete information on tumor extension. Punch matrix biopsy gives limited evidence in the diagnosis of NM

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

Onychomycosis: A Review

Onychomycosis is the most common nail infective disorder. It is caused mainly by anthropophilic dermatophytes, in particular by Trichophyton rubrum and T. mentagrophytes var. interdigitale. Yeasts, like Candida albicans and C. parapsilosis, and molds, like Aspergillus spp., represent the second cause of onychomycosis. The clinical suspect of onychomycosis should be confirmed my mycology. Onychoscopy is a new method that can help the physician, as in onychomycosis, it shows a typical fringed proximal margin. Treatment is chosen depending on the modality of nail invasion, fungus species and the number of affected nails. Oral treatments are often limited by drug interactions, while topical antifungal lacquers have less efficacy. A combination of both oral and systemic treatment is often the best choice

Nail Disorders in Children

Nail diseases in children do not account for a significant proportion of pediatric consultations, and most of the time the nails are not observed by the clinician, overlooking their importance. Specific examination of the nails is neglected, while localization to the nails could be an initial sign of a syndrome or a systemic disorder. Nail diseases in the pediatric population differ from those in adults in terms of diagnostic approach and management; some of them even are manifested mainly or exclusively in children. Pediatric patients with underlying systemic disorders are more likely to manifest acquired disorders of the nails. Although rare, nail diseases in children are a source of anxiety for the parents. Examination of the nails is an essential part of pediatric physical examination. A correct clinical history and careful examination help the clinician to distinguish the different conditions and to decide on the correct management of nail diseases in young patients. A classification of nail dystrophies according to age is somewhat arbitrary and a unique classification does not exist. Nail diseases in the pediatric population can be divided according to age groups where a predilection appears in most of the cases. Moreover, certain abnormalities may be lifelong once acquired, but their presentation may be modified by age, worsening or improving during life. This review describes many of the nail conditions that are seen in the pediatric population aging from newborn to toddler, starting with physiological aspects to better recognize the pathological conditions