An unusual case of Koebner phenomenon.

Not reques

Acneiform eruption induced by ethosuximide.

Not reques

Quality of life in patients with anogenital warts.

Background: Anogenital warts (GW) are among the most common sexually transmitted diseases. Few studies have investigated the quality of life (QoL) of GW patients. Objective: We undertook an exhaustive description of the health status of GW patients and assessed disease impact on QoL. Methods: GW patients enrolled at the Sexually Transmitted Diseases service of Rome Catholic University were administered the SF-36 questionnaire to assess health status, the Skindex-29 to evaluate the impact of dermatological aspects and the GHQ-12 questionnaire to identify patients with probable minor psychiatric non-psychotic conditions. Clinical severity was assessed with the Physician Global Assessment (PGA) and through quantitative measures. Results: There was a significant association between greater disease severity and lower SF-36 values (reflecting a worse QoL). The severity parameters showed no significant differences in any of the Skindex-29 scales except for Emotions, which showed higher values (reflecting a worse QoL) in patients with severe disease assessed by PGA. The GHQ-positive patients (23.7%) consistently showed worse QoL scores on all the SF-36 scales and on all the Skindex-29 scales compared to GHQ-negative patients. Conclusions: To the best of our knowledge, this is the first study of the impact of GW on QoL to use a range of validated tools, both generic and dermatology-specific. We observed a strong influence of GW on the mental and physical components of QoL in terms of general health status (SF-36). The effects in terms of specific dermatological aspects (Skindex-29) were less significant, but still reflected an impact on patients' emotional state

Use of acitretin in a case of giant common warts in an HIV-infected patient

Clara De Simone, Rodolfo Capizzi, Angelo Carbone, Barbara Fossati, Francesco Valenzano and Pierluigi Ameri

Acne treatment with isotretinoin in a patient with Apert syndrome

A

Clinical experience of imiquimod 3.75% for actinic keratosis: results from a case series

In clinical studies, imiquimod 3.75% was shown to detect and treat actinic keratosis (AK) lesions across an entire sun-exposed field such as the full face or balding scalp. The aim of this study was to evaluate imiquimod 3.75% in a real-life clinical setting

Giant neglected squamous cell carcinoma of the skin

Nonmelanoma skin cancers (NMSCs) are the most common type of skin tumor, representing about one-third of all malignancies diagnosed worldwide each year. Cutaneous squamous cell carcinoma (cSCC) is the second most common form of NMSCs and the risk of cSCC invasiveness should be assessed on the basis of tumor size, anatomical location, and histological subtype. Although most cSCCs are early diagnosed and successfully treated, in a small percentage of patients with giant cSCC (maximum diameter >5 cm), metastases may occur; treatment options are limited and not really effective. We report the case of a giant metastatic cSCC that had been neglected for more than 20 years. Radiotherapy or surgery were not feasible and polichemotherapy (cisplatin, 5-fluorouracil and paclitaxel) was not effective. Therefore, the patient was treated with palliative electrochemotherapy (ECT) achieving a partial reduction of cutaneous metastasis and pain relief but unfortunately the patient died 3 months after the second ECT treatment

[Cutaneous tuberculosis: a case of difficult classification]

We describe a case of cutaneous tuberculosis in a 25-year-old Philippine man. Erythematous papulo-nodular lesions, measuring 0.5 to 1 cm, were present on lower limbs; a 2 cm nodule was located on the left flank. The examination of the skin biopsy showed the presence of a superficial and deep perivascular dermatitis with histiocytes, lymphocytes and plasma cells. Ziehl-Nielsen stain for mycobacterium were negative, while the cultural examination led to the isolation of M. tuberculosis. Direct smear and cultural examination of sputum for M. tuberculosis were negative; chest and skeletal roentgenograms, syphilis and HIV infection serology, haematological and hematochemical examinations and urinalysis were negative. Specific treatment with isoniazid, rifampin and ofloxacin led to a rapid remission of cutaneous lesions. This case was particularly difficult to classify, but the Authors think it would be considered a tuberculid.Abstract We describe a case of cutaneous tuberculosis in a 25-year-old Philippine man. Erythematous papulo-nodular lesions, measuring 0.5 to 1 cm, were present on lower limbs; a 2 cm nodule was located on the left flank. The examination of the skin biopsy showed the presence of a superficial and deep perivascular dermatitis with histiocytes, lymphocytes and plasma cells. Ziehl-Nielsen stain for mycobacterium were negative, while the cultural examination led to the isolation of M. tuberculosis. Direct smear and cultural examination of sputum for M. tuberculosis were negative; chest and skeletal roentgenograms, syphilis and HIV infection serology, haematological and hematochemical examinations and urinalysis were negative. Specific treatment with isoniazid, rifampin and ofloxacin led to a rapid remission of cutaneous lesions. This case was particularly difficult to classify, but the Authors think it would be considered a tuberculid

Human Papillomaviruses, p16^INK4aand Akt expression in basal cell carcinoma

Abstract Background The pathogenic role of beta-HPVs in non melanoma skin cancer (NMSC), is not still completely understood, and literature data indicate that they might be at least cofactors in the development of certain cutaneous squamous cell carcinomas. However, only few reports contain data on basal cell carcinoma (BCC). The HPVs interact with many cellular proteins altering their function or the expression levels, like the p16INK4a and Akt. Our study aimed to determine the presence of different beta -HPV types and the expression of p16INK4a and Akt in BCC, the commonest NMSC, in the normal appearing perilesional skin and in forehead swab of 37 immunocompetent patients. Methods The expression of p16INK4a and Akt, by immunohistochemistry, and the HPV DNA, by nested PCR, were investigated in each sample. Results No correspondence of HPV types between BCC and swab samples was found, whereas a correspondence between perilesional skin and BCC was ascertained in the 16,7% of the patients. In BCC, 16 different types of beta HPV were found and the most frequent types were HPV107 (15,4%), HPV100 (11,5%) and HPV15 (11,5%) all belonging to the beta HPV species 2. Immunohistochemistry detected significant p16INK4a expression in almost all tumor samples (94,3%) with the highest percentages (> 30%) of positive cells detected in 8 cases. A statistically significant (p = 0,012) increase of beta HPV presence was detected in p16INK4a strongly positive samples, in particular of species 2. pAkt expression was detected in all tumor samples with only 2 cases showing rare positive cells, whereas Akt2 expression was found in 14 out of 35 BCC (40%); in particular in HPV positive samples over-expressing p16INK4a. Conclusions Our data show that p16INK4a and pAkt are over-expressed in BCC and that the high expression of p16INK4a and of Akt2 isoform is often associated with the presence of beta-HPV species 2 (i.e. HPV 15). The association of these viruses with the up-regulation of p16INK4a and Akt/PI3K pathway suggests that in a subtype of BCC these viruses may exert a role in the carcinogenesis or in other, still undefined, biological property of these tumors. If this particular type of BCC reflects a different biology it will remain undisclosed until further studies on a larger number of samples will be performed.</p