Fotodermatosi

Le fotodermatosi in età pediatrica rappresentano un vasto capitolo delle patologie dermatologiche. La luce solare è in grado di produrre malattie caratterizzate da fotosensibilità. Il capitolo focalizza l'attezione soprattutto su le fotodermatosi autoimmuni e quelle mediate da sostanze chimiche. Fra le prime vengono trattate soprattutto la dermatite polimorfa solare, l'orticaria solare e l'hydroa vacciniforme; fra le seconde la gran parte è rappresentata da reazioni fototossiche a vegetali (fitofotodermatiti, cosmetici e farmaci sia topici che sistemici

Efficacy and tolerability of a topical gel containing 3% hydrogen peroxide, 1.5% salicylic acid and 4% D-panthenol in the treatment of mild-moderate acne

The aim of this paper was to evaluate efficacy and tolerability of a topical gel (ACNAID TM gel medical device) containing 3% hydrogen peroxide (HPO), 1.5% salicylic acid (SA) and 4% D-panthenol (D-p) in the treatment of mild-moderate acne, comparing it with a previous formulation (ACNAID TM gel Cosmetic) containing 4% HPO, 0.5% SA, 4% D-p

Certainty diagnosis of scabies in vivo by epiluminescence microscopy

Scabies represents a frequent and well-known skin disease provoked by infestation of Sarcoptes scabiei var hominis. It is characterized by severe generalized pruritus and by the presence of pathognomic burrows caused by the female arachnid in the epidermis. Often there are secondary symptoms such as pomphos, papules, vesicles or burrows and nodules. Currently, the diagnosis of scabies is established by optical microscopy identification of the mite, or ova in skin scraping removed from a linear or serpiginous elevation of skin in the form of a ridge 0.5-1 cm in length. Nevertheless occasionally even when numerous characteristic scabies symptoms are present, the scrape of burrow can be negative in optical microscopy. The authors showed a specific epiluminescence microscopic pathognomic picture of scabies, that can attribute a high diagnostic resolution to this technique. In respect to optical microscopy, epiluminescence permits the observation of an extended skin surface and reduces the possibility of false negative tests

Misdiagnosed atopic dermatitis: Case report

We report a case of a healthy 12-year-old female, who presented a large eczema of the face for more than 2 months. After microbiologic examination a diagnosis of atopic dermatitis with Staphylococcus aureus colonization was done. A combined topical corticosteroid- oral antibiotics therapy allowed to obtain a good clinical response. There was no recurrence 6 months after the treatment. Our case highlights that sometimes staphylococcal skin infections affecting atopic dermatitis can lead to misdiagnosis

The melanin pigmentation: cellular and biomolecular mechanisms

Several factors are determinant for the color of human skin: the thickness of the stratum corneum, the speed of blood flow, the degree of oxygenation of hemoglobin but the main role is played by the presence of pigments such as carotenoids and, above all, melanin. The amount and the type of melanin is genetically determined, but they are strongly influenced by the other conditions such as hormonal and environmental: age, presence of metal ions, and inflammatory processes, and specifically exposure to sunlight. In vertebrates, melanocytes cells, responsible for the production of melanin, have the main function, but not exclusively, to protect the skin from the genotoxic stress produced by ultraviolet rays (UV); melanin absorbs the UV and neutralizers reactive oxygen species (ROS) they produce. Some studies clarified, at least in part, enzymatic and non enzymatic factors involved in the biosynthesis of melanin and the molecular mechanisms underlying the different responses of skin pigmentation to external stimuli, particularly to solar radiation. In this review we want to revise the cellular and biochemical aspects of skin pigmentation

UV-selective face cream (Acne RA-1,2) in acne patients: clinical study of effects on epidermal barrier function, sebum production, tolerability and adherence to pharmacological therapy.

BACKGROUND: General skin care recommendations such as the use of moisturisers and products with adequate photoprotection are important components of management for acne patients to complement the medical regimen. This study aimed to evaluate the real-life clinical effects of a novel UV-selective face cream (Acne RA-1,2) on acne, epidermal barrier function, sebum production, adherence and tolerability when used together with pharmacological acne treatment. METHODS: 40 patients receiving pharmacological acne treatment applied Acne RA- 1,2 once-daily for 3 months. Investigator's Global Assessment of acne, trans- epidermal water loss, sebum production and tolerability were assessed after 1 and 3 months. RESULTS: After 3 months, there was a 38% significant clinical improvement in mean Investigator Global Assessment score (3.4 to 2.1), a 29% significant reduction in trans-epidermal water loss (13.2 to 9.4 g/h/m2), and a 17% significant decrease in sebum production vs baseline (234.6 to 195.6 μg/cm2; all p<0.01). 100% of patients reported complete adherence to pharmacological therapy over the summer of the study vs 52.5% in the previous summer. 87.5% considered their acne improved over the summer of the study vs 55.0% in the previous summer. Pruritus, erythema, dryness and total tolerability symptom scores were significantly reduced after 3 months vs baseline (p<0.05). CONCLUSIONS: Acne RA-1,2 is a useful daily adjunct to pharmacological therapy as it helps to mitigate the irritation these therapies cause, increasing adherence to therapy, and leading to a clinical improvement in acne and epidermal barrier function and a decrease in sebum productio

The role of camouflage in the management of skin damages in oncologic patients

Neoplastic disease and its therapeutic options have a huge impact on the patient's quality of life from both the emotional and the working point of view. Sociological research has revealed that gender also plays an important role in the emotional reaction to the disease. When faced with a neoplastic disease, men and women show significantly different reactions: women, as wives and mothers, are more subject and vulnerable to stress and they can have major psychological implications for the severe impact on body image. In 2002, at the Dermatological Clinic of the University of Naples "Federico II", Corrective Dermacosmetological Laboratory was activated to teach the most suitable techniques in order to disguise skin imperfections by means of an easily reproducible maquillage. Since 2010 the Laboratory is activating to help oncologic patients learn the best way of hiding temporary or permanent skin damages that cause serious discomfort because of the aesthetic modifications of their image. The corrective dermacosmetological camouflage is a technique aiming to learn to oncologic patients the best way of hiding temporary or permanent skin damages related to chemotherapy and radiotherapy: it is also important to contain any cicatricial results. At the laboratories of Naples 36 patients have been treated, 31 women and 5 men, aged between 19 and 72 years. The camouflage technique depends basically on the use of a number of opaque covering non irritant, hypoallergenic creams and powders of superior duration if compared to standard cosmetics. Results were supported by photos showing the excellent results achieved with this technique. Furthermore, an improvement in psychological problems caused by skin damages related to chemotherapy, radiotherapy and surgery therapy was observed in all patients

Acneiform rash induced by EGFR inhibitors: review of the literature and new insights

Acneiform rash is the most common side effect of epidermal growth factor receptor (EGFR) inhibitors (EGFRis), and it occurs in 50-100% of patients. This condition can affect the quality of life of these patients and can sometimes lead to a discontinuation of the antineoplastic therapy. Several recent prospective studies have addressed and evaluated different interventions to mitigate or reduce the severity of EGFRis-associated skin rash. With this aim, we have established a dermocosmetological outpatient clinic for cancer patients at the Department of Clinical Medicine and Surgery, University of Naples Federico II in collaboration with the Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami. An interdisciplinary network of physicians can improve the quality of life of the cancer patients, focusing on such important aspects as dermocosmetological skin care, but also on the evaluation of new therapeutic and diagnostic algorithms in order to make further progress in the field of prevention. In this review, we summarize the state of the art of the epidemiology, pathogenesis, and treatment of EGFRis acneiform rash, and we describe our outpatient clinical experience

Photodynamic therapy: a treatment tool for hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating inflammatory disease of unknown aetiology. The current standard of care for HS includes antibiotics (oral/topical), retinoids (oral/topical) and intralesional steroids. However, the recurrence of the disease and the unsuccessful of the different treatments stimulate findings of different therapy using light source. Among these, photodynamic therapy with 5-aminolevulinic acid (ALA-PDT) has been proposed by some authors recently. In this study we report the experience of 15 patients affected by HS resistant to conventional therapy treated with ALA-PDT