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

Acne Smart Club: An Educational Program for Patients with Acne

Objective: To evaluate adherence to therapy in acne patients using mobile phones and Short Message Service (SMS) to communicate. Methods: 160 patients were randomly assigned to two groups: the SMS group received 2 text messages twice a day for a period of 12 weeks; the control group did not receive any messages. Before and after 12 weeks, the following evaluations were performed in all patients: digital photographs, the Global Acne Grading System, the Dermatology Life Quality Index, the Cardiff Acne Disability Index, the doctor-patient relationship evaluated through the Patient-Doctor Depth-of-Relationship Scale, and the adherence to treatment evaluated by asking patients how many days a week they had followed the therapy. For statistical analysis we used Student's t test. Results: The SMS group had a better improvement of all parameters compared to the control group. Conclusion: Adherence and compliance are higher for patients who are included in a strategy of control. © 2014 S. Karger AG, Basel

Salicylic acid for the treatment of melasma: new acquisitions for monitoring the clinical improvement.

OBJECTIVE: The Melasma Area and Severity Index (MASI) and the Melasma Severity Score (MSS) are calculated on the basis of only a subjective clinical assessment. This raises the need to have an objective score, uniform in the evaluation by different clinicians. The purpose of this study was to establish if the images by Canfield Reveal Imager can be correlated to MASI score to better evaluate the clinical efficacy of salicylic acid 33% peeling in the treatment of melasma respect to the clinical observation. METHODS: The study was a voluntary observational study. Twenty female patients affected with melasma, aged between 30 and 60 years, were included in the study. Treatment with salicylic acid 33% was performed once a month, for a total of four times. The dermatologist (Doc A) examined each patient's melasma areas using MASI score, at the face-to-face observation and at Reveal images evaluation during the first (T0) and the end point time (T4). Digital photographs were also evaluated by another experienced dermatologist (Doc B), who has never seen clinically the patients before and who evaluated MASI score by Reveal images at time T0 and T4. RESULTS: Student's t-test and linear regression test were performed, showing statistically significant values comparing MASI score obtained by digital photo and MASI score obtained clinically. CONCLUSION: The monitoring of the improvement by Reveal images can optimize the treatment approach and the efficacy of same dermocosmetics procedures can be revised following standard criteria

Langerhans' cell histiocytosis of the vulva: The use of photodynamic therapy

Background: The evaluation of possible efficacy of Photodynamic Therapy (PDT) in a rare condition of vulvar Langerhans' cell histiocytosis (LCH), in a 43-years-old women with one year history of pruritic vulvar lesions. Main observations: After a cycle of 5 sessions of PDT, with aminolevulinic acid (ALA) in low percentage (5%), the patient reported an improvement of lesions, and an high improvement of local symptoms, with a significant reduction of itch and pain. Conclusions: Our case confirms this single experience of literature for the treatment of vulvar LCH by PDT, with an improvement of disease's symptoms, and can suggest the use of PDT for this rare and untreated disease

Assessment of capillary volumetric blood microsampling for the analysis of central nervous system drugs and metabolites

Therapeutic drug monitoring (TDM) is an important tool for correlating the administered drug dose to drug and metabolite concentrations in the body and to therapeutic and adverse effects. In the case of treatment with drugs active on the central nervous system (CNS), frequent TDM becomes really useful, especially for patient compliance checking and for therapy optimisation. The selective serotonin reuptake inhibitors (SSRIs) fluoxetine and sertraline, chosen as target compounds for this study, are two antidepressants mainly used for major depression, but also for obsessive-compulsive disorder associated with neurodegenerative diseases and for eating disorders. Microsampling approaches can be used to make TDM patient-friendly, by means of minimally invasive fingerpricking instead of classic invasive venipuncture. In this study, an innovative volumetric microsampling approach based on the use of hemaPEN technology is proposed to simultaneously obtain four identical dried whole blood microsamples by means of a single capillary sampling. The developed strategy shows significant advantages in terms of blood collection and storage, fast and feasible extraction procedure and sensitive LC-MS/MS analysis, also providing satisfactory validation results (extraction yield >81%, RSD <12.0%, and <6.3% loss in analyte stability after 3 months). The proposed methodology has proven to be sound and reliable for application to the TDM of psychiatric patients treated with antidepressant drugs such as fluoxetine and sertraline. The original capillary volumetric microsampling procedure using hemaPEN has been demonstrated to be suitable for the accurate sampling of capillary whole blood, in order to be successfully exploited in self- and home-sampling procedures in future and to pave the way for precision medicine approaches for the treatment of CNS disorders

A dietary supplement to reduce side effects of oral isotretinoin therapy in acne patients.

AIM: The purpose of the study was to analyze the potential capacity of a dietary supplement, based on gamma linolenic acid, vitamin E, vitamin C, beta-carotene, coenzyme Q10 and Vitis Vitifera, to reduce side effects, in particular the dry skin, erythema and desquamation, due to treatment with oral isotretinoin, and evaluate the ability of the product to increase adherence to therapy in patients with acne. METHODS: Forty-eight patients with nodular acne (32 females and 16 males) were randomly divided into 2 groups: 24 receveid isotretinoin therapy (20-30 mg/day) for 6 months associated to dietary supplement (twice a day), while the other 24 patients received only isotretinoin (20-30 mg/day) for 6 months. For all patients the degree of acne severity, through GAGS (Global Acne Grading System), the sebum production by Sebutape, the hydration by Corneometer and the erythema by Mexameter, were measured. We have also evaluated the adherence to treatment, asking to patients how many days a week they follow the therapy. RERSULTS: Patients treated with dietary supplement had lower side effects, with a less degree of erythema and dryness, and greater degree of hydration; a greater adherence to therapy was also reported. CONCLUSION: Thanks to antioxidant and moisturizing properties, the dietary supplement containing gamma linolenic acid, vitamin E, vitamin C, betacarotene, coenzyme Q10 and Vitis Vitifera, can be considered a useful supplement in the treatment and prevention of dry skin associated with the use of oral isotretinoin

A new classification and clinical predictivity for some naevus variants

Background. The incidence of cutaneous melanoma is rapidly increasing in Europe. Active research is directed toward the identification of naevi as a risk factor. Objective. The aim of our case-control study was to observe different numbers of moles and different mole typology associations in order to evaluate clinical predictivity and to establish a new classification for some naevus variants. Methods. A case-control study was carried out, enrolling 64 cases affected by melanoma and 183 controls, between October 2009 and February 2011. Each patient was interviewed and subjected to clinical examination. The resulting data were analysed using the statistical elaboration program SPSS 16.0. Results. The association of target naevus with other variants increases the degree of risk (target + small brown Odds Ratio 5.25; confidence interval 1.8-15.4); (target + small brown + small black + large brown odds ratio 5.0; confidence interval 1.1-22.4). Therefore, other variants and/or other variant combinations do not significantly increase risk. Conclusion. People presenting two naevus variants in association with other naevus variants seem to run a major risk. The general nonuniformity of the whole naevus panorama should be carefully considered

Role of Notch2 pathway in mature B cell malignancies

In recent decades, the Notch pathway has been characterized as a key regulatory signaling of cell-fate decisions evolutionarily conserved in many organisms and different tissues during lifespan. At the same time, many studies suggest a link between alterations of this signaling and tumor genesis or progression. In lymphopoiesis, the Notch pathway plays a fundamental role in the correct differentiation of T and B cells, but its deregulated activity leads to leukemic onset and evolution. Notch and its ligands Delta/Jagged exhibit a pivotal role in the crosstalk between leukemic cells and their environment. This review is focused in particular on Notch2 receptor activity. Members of Notch2 pathway have been reported to be mutated in Chronic Lymphocytic Leukemia (CLL), Splenic Marginal Zone Lymphoma (SMZL) and Nodal Marginal Zone Lymphoma (NMZL). CLL is a B cell malignancy in which leukemic clones establish supportive crosstalk with non-malignant cells of the tumor microenvironment to grow, survive, and resist even the new generation of drugs. SMZL and NMZL are indolent B cell neoplasms distinguished by a distinct pattern of dissemination. In SMZL leukemic cells affect mainly the spleen, bone marrow, and peripheral blood, while NMZL has a leading nodal distribution. Since Notch2 is involved in the commitment of leukemic cells to the marginal zone as a major regulator of B cell physiological differentiation, it is predominantly affected by the molecular lesions found in both SMZL and NMZL. In light of these findings, a better understanding of the Notch receptor family pathogenic role, in particular Notch2, is desirable because it is still incomplete, not only in the physiological development of B lymphocytes but also in leukemia progression and resistance. Several therapeutic strategies capable of interfering with Notch signaling, such as monoclonal antibodies, enzyme or complex inhibitors, are being analyzed. To avoid the unwanted multiple “on target” toxicity encountered during the systemic inhibition of Notch signaling, the study of an appropriate pharmaceutical formulation is a pressing need. This is why, to date, there are still no Notch-targeted therapies approved. An accurate analysis of the Notch pathway could be useful to drive the discovery of new therapeutic targets and the development of more effective therapies

Desempenho de frangos de corte (22 a 42 dias) alimentados com dietas peletizadas contendo glicerina bruta.

A maior parte das rações produzidas para frangos de corte no Brasil são peletizadas. Como benefício deste processamento observa-se melhora na digestibilidade dos nutrientes, redução de contaminações por patógenos, bem como melhorias nas condições de transporte. Existem muitos aditivos umectantes que podem ser utilizados para melhorar o processo de peletização, contudo a glicerina além de ser um umectante eficiente (1) é um alimento energético que tem grande potencial de produção no país. Assim sendo, objetivou-se avaliar o desempenho de frangos de corte na fase final (22 a 42 dias) alimentados com rações peletizadas ou fareladas com a inclusão de níveis crescentes de glicerina bruta