Treatment of actinic keratosis with nicotinamide-associated photodynamic therapy versus treatment with photodynamic therapy alone: ​​an observational study.

Le cheratosi attiniche (actinic keratosis, AK) sono le neoformazioni epiteliali di più comune riscontro nella pratica clinica dermatologica. La maggior parte delle terapie attualmente utilizzate per le AK sono terapie “di campo”, ossia volte a trattare l’intero campo di cancerizzazione, cioè l’insieme delle lesioni, sia cliniche sia subcliniche, che si sviluppano in seguito all’accumulo di modificazioni pre-neoplastiche in una regione di epitelio in seguito all’esposizione a lungo termine ad agenti cancerogeni, in questo caso i raggi ultravioletti. La terapia fotodinamica (photodynamic therapy, PDT), che può essere svolta nella modalità “convenzionale” (utilizzando una luce rossa) oppure “daylight” (utilizzando la luce naturale), è una metodica ampiamente utilizzata nella terapia di AK multiple e campo di cancerizzazione. La recente letteratura ha mostrato come la nicotinamide (forma attiva della vitamina B3) possa essere in grado di ridurre l’insorgenza di nuove AK e tumori cutanei non-melanoma, potendo favorire il processo di riparazione del DNA e ridurre l’immunosoppressione legata all’esposizione cronica agli UV. Pochi studi si sono concentrati sui possibili legami fra PDT e trattamento con nicotinamide, ed in particolare sul loro effetto combinato nel trattamento delle AK. Questo studio è volto a comparare gli outcomes di due differenti trattamenti, ossia la PDT associata a nicotinamide per os, rispetto alla sola PDT, per il trattamento di AK multiple e del campo di cancerizzazione nel distretto testa-collo.Actinic keratosis (AK) is the most common epithelial neoformation in the clinical practice. Most of the treatments of AK are “field” therapies, i.e. aimed at treating the “field of cancerization”, which consists of all the lesions, both clinical and subclinical, that develop after the accumulation of pre-neoplastic modifications due to long-term exposure to carcinogens, in this case ultraviolet (UV) radiation. Photodynamic therapy (PDT), which can be performed with the conventional technique (using red light) or with the daylight technique (using natural radiation), is widely used for the treatment of multiple AKs and field of cancerization. The recent literature has shown that nicotinamide (the active form of vitamin B3), may reduce the onset of new AKs and non-melanoma skin cancer, since it can promote DNA repair process and reduce the immunosuppression linked to UV-exposure. Only few studies have focused on the possible associations between PDT and nicotinamide, and in particular on the combined effect of PDT and nicotinamide in the treatment of AK. This study aims to compare the efficacy of two different treatments, i.e. PDT associated with systemic nicotinamide and PDT alone, for the treatment of multiple AKs and field of cancerization in the head and neck district

An Atypical Presentation of Extragenital Lichen Sclerosus et Atrophicus

open6noLichen Sclerosus et Atrophicus is a chronic inflammatory,invalidating disorder mainly involving the anogenital skin. Extragenital lesions are uncommon, occurring asmultiple, oval, porcelain-white macules, or papules. Whenpresent, they are mostly observed on the superior trunk, axillae, buttocks, and extremities, following Blaschko lines.openSabina Vaccari, Alessia Barisani, Francesca Pepe, Carlotta Baraldi, Bianca Maria Piraccini, Valeria GaspariSabina Vaccari, Alessia Barisani, Francesca Pepe, Carlotta Baraldi, Bianca Maria Piraccini, Valeria Gaspar

In Situ Melanoma of the Nipple and Areola: A Dermoscopic Report in Two New Cases

none4nono abstract requirednoneGiulio Tosti, Camilla Salvini, Alessia Barisani, Sabina VaccariGiulio Tosti, Camilla Salvini, Alessia Barisani, Sabina Vaccar

Solitary erythematous, tender plaque of the heel in a young infant

Calcinosis cutis is a rare disorder resulting from the precipitation and deposition of insoluble calcium and phosphate salts (hydroxyapatite crystals) in the dermis and subcutaneous tissue. It is generally divided into four main groups on the basis of etiology and pathogenesis. Clinical presentation of cutaneous calcinosis cutis varies according to the diagnosis and the underlying process. We report a case of calcinosis cutis of the heel in which both the extravasation of a calcium gluconate infusion and renal failure could have promoted the development of calcinosis cuti

Solitary erythematous, tender plaque of the heel in a young infant

Calcinosis cutis is a rare disorder resulting from the precipitation and deposition of insoluble calcium and phosphate salts (hydroxyapatite crystals) in the dermis and subcutaneous tissue. It is generally divided into four main groups on the basis of etiology and pathogenesis. Clinical presentation of cutaneous calcinosis cutis varies according to the diagnosis and the underlying process. We report a case of calcinosis cutis of the heel in which both the extravasation of a calcium gluconate infusion and renal failure could have promoted the development of calcinosis cuti

Photodynamic therapy following fractional CO2 LASER for treatment of primary vulvar Paget's disease: does it really works?

Abstract Introduction: Extra-mammary Paget\u2019s disease is a rare form of intraepithelial adenocarcinoma with a variable pattern of invasion. Vulvar Paget\u2019s disease represents 1% of all vulvar cancers. Standard treatment is surgical excision, however, the recurrence rate is high and surgery leads to anatomical, functional and sexual morbidity. Some studies suggest the efficacy of photodynamic therapy following CO2 Laser irradiation as treatment for this disease. Methods: In the present study, ten patients with vulvar Paget\u2019s disease underwent fractional carbon dioxide (CO2) laser abrasion, followed by 3\u2009h of occlusive application of aminolaevulinic acid (ALA) and then 100\u2009J/cm2 irradiation with a 630-nm lamp. This combination treatment regime was repeated every 2\u2009weeks for a total of 5 times. Results: At the end of the 12-month follow-up period, only two patients maintained a complete remission of the disease and recurrence was observed in all patients who had originally shown a partial remission. Conclusions: According to our experience, Photodynamic Therapy-ALA following fractional CO2 Laser does not seem to be an effective treatment for vulvar EMPD in the long term

Plaque-like myofibroblastic tumor, a rare entity of childhood: Possible pitfalls in differential diagnosis

Plaque-like myofibroblastic tumor is a rare and benign pediatric soft tissue tumor. It presents as a slowly growing plaque reaching several centimeters in diameter, made up of multiple nodules. The clinical and histological features of this benign entity are similar to other fibrohistiocytic or myofibroblastic tumors occurring in childhood, so the diagnosis can be difficult. The correlation between clinical data, histopathology, and immunohistochemistry is necessary for the correct diagnosis

A dermatoscopic portrait of morphological changes of vulvar melanosis over time

a peculiar dermoscopic pattern of vulvar melanosis is described

Vegas xanthoma: a challenging diagnosis in dermatology

no abstract availabl