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

Tyndall discoloration and filler injections: A possible side effect

One of the possible side effects that may occurred after injection of hyaluronic acid (HA) filler substances is the appearance of blue-grey discoloration of the skin in the site of injection due to the so called Tyndall effect. In this brief case report, we describe such adverse reaction occurred in a 48 years old female patient and its treatment

Aesthetic procedures side effects: Nodules and long lasting oedema in filler implantation

Side effects can occur after hyaluronic acid (HA) fillers injection. In this brief report, we present 5 cases of fillers injection's side effects: 4 patients with persistent nodules after HA injection into glabella, nasolabial folds, lips, and infraorbital area and 1 patient with long lasting oedema of the lip

Photoprotective properties of Olea Europea by topical application versus UVB and Vitamin E acetate

The aim of the present study was to assess the photoprotective, lenitive and antioxidant properties of Olea Europea (OE) versus UVB and Vitamin E acetate. The Olea Europea is a pool of functional highly specific and differentiated molecules, with antioxidant activities and "scavenger" mechanisms, since oxidative stress linked to the formation of free radicals exerts an important role in the UV-induced skin damage. 21 healthy subjects were studied during a 4-month study. They were subdivided into 3 groups (A, B and C), each formed by 7 patients. They all were irradiated with a source of UVB and evaluated by colorimeter. In A group patients, following application of Olea Europea, we observed a 22% erythema decrease respect to MED; in B group patients, it was approximately 32%, in C group, it was about 18%. OE presented high efficacy, especially when it was applied both before and after photostimulation; results were more important when OE was combined with pure vitamin E acetate (reaching, respectively, 31%, 60% and 40% erythema decrease). Olea Europea, when topically applied, presents interesting capabilities of repairing UVB photodamage; therefore, OE integrates the peculiar and natural functional characteristics of skin photoprotection

Confocal Microscopy Images to Monitor Skin Needling in the Treatment of Acne Scars

Background: Acne is a common and generally self-limiting skin disease. However, the severe sequel of acne scarring can lead to long-term psychological impairment. Although the occurrence of post-acne scarring, especially in the cases of papulopustular and nodulo-cystic variants, remains unknown, its incidence is extremely common. There is a wide range of modalities used in the treatement of acne scars such as surgical techniques, subcision, chemical peels, ablative lasers, fractional lasers and collagen induction therapy. Reflectance confocal microscopy is a new noninvasive technique for the examination of the skin "in vivo", which can be useful to evaluate the effectiveness of different therapeutic approaches. Aims: The aim of this study is to evaluate the modification and the improvement induced by skin collagen induction on acne scars through the use of confocal microscopy. Methods: 30 patients, who had previously been diagnosed with acne scars, were selected. All patients were clinically evaluated according to the qualitative grading scale of acne scars proposed by Goodman and Baron. In addition, quality of life was also assessed using DLQI. Finally, all patients were evaluated using GAIS system. Skin collagen induction (Dermaroller®) was performed in one session, with follow up assessments at 30 (T1) and 60 days (T2). In 10 patients confocal microscopy was performed at T0 and T2. Results: 28 out of 30 patients showed clinical improvement of acne scars and in all 10 patients confocal microscopy showed improvement of the texture and collagen neosynthesis induced by skin collagen induction. Conclusions: Skin needling is a very effective treatment for acne scars. Confocal microscopy observation can better define the modification induced by skin needling in the treatment of acne scars and open new perspectives on this treatment

Dermoscopy patterns of fibroepithelioma of pinkus

Background: Fibroepithelioma of Pinkus ( FeP) is a rare variant of basal cell carcinoma that may clinically mimic a number of benign skin tumors. While the dermoscopic features of basal cell carcinoma have been studied extensively, little is known about the dermoscopic features of FeP. Observations: Retrospective evaluation of clinical records and digital clinical dermoscopic images of 10 histopathologically proved FePs ( 6 nonpigmented and 4 pigmented) was performed. Clinically, no FeP was correctly identified and, in half of all patients, a clinical differential diagnosis of purely benign skin lesions was made. Dermoscopy enabled the correct diagnosis in 9 of 10 FePs, based on the presence of fine arborizing vessels, either alone or associated with dotted vessels, and white streaks ( in 100%, 70%, and 90% of lesions, respectively). In the 4 pigmented FePs, a structureless gray- brown area of pigmentation and variable numbers of gray- blue dots were observed, in addition. Conclusions: Dermoscopy is helpful in diagnosing FeP and in differentiating this variant of basal cell carcinoma from other benign skin tumors commonly included in the clinical differential diagnosis. This presumes, however, that dermoscopy is used as a first- line examination for all skin lesions, not only for those that are clinically suspect

Epiluminescence Image Processing for Melanocytic Skin Lesion Diagnosis Based on 7-Point Check-List: A Preliminary Discussion on Three Parameters

Epiluminescence microscopy (ELM) is a non invasive technique used to enhance visualization of microscopic structures of pigmented lesions for the early detection of melanoma. The 7 point check list is a diagnostic method that requires the identification of only seven dermoscopic criteria, defining the image through the use of algorithms. This paper describes an experimental automated diagnosis set up of melanocytic skin lesions through an image processing methodology focused on finding the presence of different epiluminescence parameters. In this paper the image processing set up allows the automatic detection of some specific dermoscopic criteria. We analyze the blue whitish veil, the regression, and the irregular streaks. The procedure developed was tested by considering a set of about 200 ELM images. A good concordance between ELM 7 point checklist parameters detected and the new method of image processing was achieved by kappa analysis. Although ELM doesn’t substitute histological evaluation, it could be a reliable instrument to enhance clinical accuracy of skin pigmented lesions diagnosis

The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions

BACKGROUND: Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy. OBJECTIVES: We sought to estimate the prevalence and assess the clinical significance of CS in melanocytic and nonmelanocytic lesions. METHODS: This was a prospective observational study in which dermatoscopic assessment of lesions was recorded in consecutive patients examined during a 6-month period. In addition, a data set of biopsy-proven melanomas was retrospectively analyzed. RESULTS: In all, 11,225 lesions in 881 patients were prospectively examined. Retrospectively, 229 melanomas imaged with polarized dermatoscopy were analyzed. In the prospective data set, a median of 12.7 lesions (range, 1-54) were evaluated per patient. None of clinically diagnosed Clark nevi (n = 9750, 86.8%) demonstrated CS. Overall, CS were observed in 206 (1.8%) lesions, most commonly dermatofibromas and scars among nonbiopsied lesions. A total of 265 (2.4%) lesions were biopsied, including 20 melanomas and 36 nevi. Among biopsied malignant lesions, CS were most commonly observed in basal cell carcinoma (47.6%) and invasive melanomas (84.6%). Melanomas were more likely to have CS than biopsied nevi (odds ratio = 9.7, 95% confidence interval 2.7-34.1). In the retrospective data set, CS were more commonly observed among invasive melanomas (41%) compared with in situ melanomas (17%) (odds ratio = 3.4, 95% confidence interval 1.9-6.3, P < .001). The prevalence of CS correlated with increased melanoma thickness (P = .001). LIMITATIONS: Biopsied lesions represent a small percentage of the total number of lesions evaluated. CONCLUSION: Among biopsied malignant lesions, CS are most commonly observed in basal cell carcinoma and invasive melanomas and rarely seen in nevi. In melanoma, CS may reflect increased tumor thickness and progression