Highlights of Thirty-Year Experience of CO2 Laser Use at the Florence (Italy) Department of Dermatology

The CO2 laser has been used extensively in dermatological surgery over the past 30 years and is now recognised as the gold standard for soft tissue vaporization. Considering that the continuous wave CO2 laser delivery system and the newer “superpulsed” and scanned CO2 systems have progressively changed our practice and patient satisfaction, a long range documentation can be useful. Our experience has demonstrated that the use of CO2 laser involves a reduced healing time, an infrequent need for anaesthesia, reduced thermal damage, less bleeding, less inflammation, the possibility of intra-operative histologic and/or cytologic examination, and easy access to anatomically difficult areas. Immediate side effects have been pain, erythema, edema, typically see with older methods, using higher power. The percentage of after-treatment keloids and hypertrophic scars observed was very low (~1%) especially upon the usage of lower parameters. The recurrence of viral lesions (condylomas and warts) have been not more frequent than those due to other techniques. Tumor recurrence is minor compared with radiotherapy or surgery. This method is a valid alternative to surgery and/or diathermocoagulation for microsurgery of soft tissues. Our results are at times not consistent with those published in the literature, stressing the concept that multicentric studies that harmonization methodology and the patient selection are vital

Lithium acne

Viene presentato il caso di una donna che presenta lesioni acneiformi dovute a sali di litio presenti nei farmaci in uso dalla paziente per terapia psichiatric

An uncommon onychomadesis in adults

Onychomadesis can be attributed to a wide variety of causes, including allergic contact dermatitis, paronychia,pustular psoriasis, and trauma, and most cases are considered to be idiopathic. Onychomadesis at the same level involving several nails suggests a systemic cause, such as fever, erythroderma, use of drugs such as anti-tumoral chemotherapeutics, carbamazepine, lithium salts, retinoids and, at the infantile age, viral infections such as Kawasaki disease, and hand, foot, and mouth disease (HFMD). HFMD generally affects children younger than 10 years old and in adults has minor manifestations and thereby easily goes unrecognized

Fingertip necrosis as a sign of carpal tunnel syndrome

Skin lesions such as finger erythema, nail dystrophy,and blisters have been described in patients with severe damage to themotor, sensory, and autonomic fibers of the median nerve. The pathogenetic hypothesis is that fingertip necrosis is caused by a transitory alteration of autonomic innervation associated with impaired arterial vascularization as a result of a lesion in the vasa nervorum. These 2 cases highlight an advanced stage of CTS as a cause of fingertip necrosi

Scleroderma-like hands in a 16-year-old boy

Viene presentato il caso di un bambino nato con porfiria eritropoietica che sviluppa lesioni a tipo sclerodermia localizzata a livello di entrambe le mani

Generalized Granuloma annulare and non-hodgkin's lymphoma

Granuloma annulare (GA) is a common, infammatory disorder, which is usually considered to have a benign progression. The generalized variant of GA is relatively rare and has been reported in association with diabetes, HIV and some malignant neoplasias, such as breast, cer- vical, lung, prostate, stomach and ovarian carcinoma. In particular, the relatively rare association of generalized GA with malignant lymphomas is not well-recognized. We describe here the presence of both generalized GA and Hodgkin’s disease (HD) in a 64-year-old woman

Pomade crust of the face

A 15-year-old Chinese boy presented to us with symmet- (a) ric crusts on his cheeks and the dorsal surface of his nose. Pomade disease (or pomade crust) is a misdiagnosed thick crusting excessively treated with topical ointments and 1 oils and not responsive to topical corticosteroids

Lip swelling as initial manifestation of Crohn's disease

none6noThe present case report depicts how lip swelling can represent the initial and sole manifestation of Crohn’s disease. It is also possible that this sign appears several years before the typical intestinal involvement.noneBruscino, Nicola*; Arunachalam, Meena; Galeone, Massimiliano; Scarfì, Federica; Maio, Vincenza; Difonzo, Elisa MargheritaBruscino, Nicola*; Arunachalam, Meena; Galeone, Massimiliano; Scarfì, Federica; Maio, Vincenza; Difonzo, Elisa Margherit