Acquired Ulcero-Mutilating Bilateral Acro-Osteopathy (Bureau-Barrière Syndrome)

We present a 35-year-old male patient with Bureau-Barrière syndrome. Bureau-Barrière syndrome is an ulcero-mutilating acropathy almost invariably associated with excessive alcohol intake. It presents with a triad of trophic skin changes with recurrent ulcerations, bone lesions and nerve damage. The clinical presentation includes chronic painless plantar ulcerations with periulcerous hyperkeratosis, hyperhidrosis, livedoid skin colour, nail dystrophy, widening and infiltration of the toes and common interdigital mycoses. Other non-specific skin changes related to the alcohol consumption are commonly observed as well. The condition affects mainly middle-aged men suffering from alcoholism. Often a bilateral location at the lower limb of male alcoholics has been described, as in our patient. Successful treatment of the Bureau-Barrière syndrome requires an interdisciplinary approach. Cessation of alcohol intake and smoking is of paramount importance

An Innovative Therapeutic Protocol for Vitiligo: Experience with the Use of Fraxel Herbium Laser, Topical Latanoprost and Successive Irradiation with UVA - 1 Laser

Despite the continuous introduction of innovative therapies for vitiligo, today none of them provide constant and excellent results in term of repigmentation. The authors report their experience in treating a localised form of vitiligo with a new protocol consisting in the use of a Fraxel Herbium laser, and in the following application of topical Latanoprost solution and, one day after, in lesional irradiation with UVA1 laser

Women in medicine and dermatology: history and advances

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology

Basal Cell Carcinoma Surgery: Simple Undermining Approach in Two Patients with Different Tumour Locations

Basal cell carcinoma (BCC) is the most common human malignancy, accounting for the majority of all non-melanoma skin cancers (NMSC). In the past several decades the worldwide incidence of BCC has constantly been increasing. Even though it is a slow growing tumour that, left untreated, rarely metastasizes, it has a distinctive invasive growth pattern, posing a considerable risk for local invasion and destruction of underlying tissues, such as muscle, cartilage, bone or vital structures. Advanced BCCs include such locally invasive or metastatic tumours. Complete surgical excision is the standard therapy for most uncomplicated BCC cases with good prognosis and cure rates. Treatment of advanced forms of BCCs poses significant therapeutic challenges, most often requiring complicated surgery, radiotherapy, and/or targeted therapies directed towards the sonic hedgehog signalling pathway (SHH). We present two cases of large BCCs located on the scalp and posterior thorax, which underwent surgical excision with clear margins, followed by reconstruction of the defect after extensive undermining of the skin

Topical Probiotics in Dermatological Therapy and Skincare: A Concise Review

Recent studies have produced an increasing body of evidence that the intestinal microbiome plays an essential role in modulating systemic inflammation and skin diseases. The gut microbiome influences and modulates the host immune system, enabling immune tolerance of environmental and dietary antigens and protecting against pathogens. Emerging scientific evidence has demonstrated that oral probiotics can help treat certain skin diseases, such as acne, atopic dermatitis, photoaging, psoriasis, and wound healing. The aim of this paper is to review the current scientific evidence on topical probiotics and their effects on dermatological diseases and skincare and to clarify if the application of exogenous probiotics could also have the same benefit as oral probiotics in promoting positive bacterial balance to treat dermatologic conditions

Environmental Psychodermatology: Stress, Environment and Skin

The skin is responsible for protecting internal organs from noxious substances, including toxic chemicals, ultraviolet radiation and repeated exposure to water. It is an important interface between man and environment and is a portal of entry for different hazardous agents. Environmental stressors refer to biological, physical and chemical constraints on the productivity of species and on the development of ecosystems. Everyday life is full of environmental stressors that can cause skin diseases. This chapter presents the interesting and complex correlation between stress, environment and skin diseases

Psoriasis

Psoriasis is a chronic inflammatory multi organ disease that affects 1–3 % of the general population. The etiology of psoriasis is not fully understood. It is considered a multifactorial disease that involves both genetic environmental influences. Among these factors, stress has been considered as an important role in the onset and exacerbation of psoriasis Heller (Skin Therapy Lett 16(5):1–4, 2011). Psychological stress may be also a consequence of psoriasis. Social stigmatization, rejection by the family and friends with consequent profound effect on self-confidence, self-image and sense of well being are most commonly seen in psoriasis patient. Psychiatric comorbidity in psoriasis patients is well documented in the literature. It is highly recommended that every patient of psoriasis should be thoroughly evaluated for the psychosocial percussions of the disease

Psychodermato-Oncology and Stress

Skin cancer is the most common type of cancer around the world affecting specially fair-skinned populations. There are three types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma, originating from three major types of cells in the epidermis. Stress can affect, reveal or even exacerbate a number of skin disorders. Stress suppresses immune function and increases susceptibility to infections and skin cancers. In the other hand, receiving the diagnosis of skin cancer can be a stressful event and patients may go through an array of emotional reactions including anxiety and depression. This chapter presents the correlation of skin cancers and stress in different manners