Unconventional Treatments for Vitiligo: Are They (Un) Satisfactory?

The authors show a brief overview of the vitiligo’s unconventional therapies. A part for well-documented effectiveness of L-phenylalanine, PGE2 and antioxidant agents in the treatment of vitiligo, for the other therapeutical approaches more investigations are needed

Successful Treatment with UVA 1 Laser of Non - Responder Vitiligo Patients

The Authors discuss their experience in treating non-responder vitiligo patients with a UVA-1 laser. Laser Alba 355® is an innovative device of target UVA - 1 phototherapy. The present report suggests that UVA1 laser could be an applicable therapeutic option in patients with vitiligo, also for the ones who did not respond to the more conventional phototherapies

A “Yellow Submarine†in Dermoscopy

BACKGROUND: Histiocytic sarcoma (HS) is an extremely rare, non-Langerhans cell tumor. HS affects especially adults, its etiology is unknown yet. Skin could be interested by papules or nodules, single or multiple.  CASE REPORT: A Caucasian man in his late 40s came to our clinic for a naevi evaluation. During the visit, a rose papulonodular lesion was observed in the lumbar region. This lesion was completely asymptomatic, and it had been there for an indefinite period. The clinical evaluation revealed that the lesion appeared elevated, of 9 x 15 mm in dimension, symmetrical and of a homogeneous pinkish colour. The videodermoscopical evaluation revealed a homogeneous yellow central pattern, polymorphic vessels, an eccentric peripheral pigmentation and a white collar. An excisional biopsy was performed. The morphology and the expression of CD163, CD68 and/or lysozyme to the immunophenotypic analysis, revealed the true nature of the lesion.CONCLUSION: HS is usually diagnosed at an already advanced clinical stage and it has a high mortality rate even today. Dermoscopy, showing a yellow and distributed homogeneously colour, can facilitate its hard diagnosis

Herbal Compounds for the Treatment of Vitiligo: A Review

An overview of unconventional therapies for vitiligo is presented. Some herbal compounds may be considered as valid therapeutic tools for the treatment of vitiligo

Once in a Blue Moon … Rare Adnexal Tumor: From the Clinical and Videodermoscopical Aspects to the Mohs Surgery and the Histological Diagnosis

The adnexal tumours are a very heterogeneous group of lesions, more and more studied in the literature. The squamoid eccrine ductal carcinoma (SEDC) is a rare malignant variant that combines ductal structures with squamous differentiation.We report a case of dermoscopic and histological diagnosis of SEDC, treated with Mohs Surgery and with no recurrence of a tumour after 12 months of follow up

Health and Illness in History, Science and Society

Health is a fundamental human right. The World Health Organization defines it as a "state of complete physical, psychological and social well - being and not merely the absence of disease or infirmity". The health of individuals, however, is also linked to the environment in which they live and especially to their ability to adapt and integrate into their life context. The relationship with the environment is extremely important because it is that interaction that outlines the concept of normality compared to pathology. Such normality needs to be contextualised by gender, geographical origin and by the individuals’ living conditions: as a matter of fact, what is normal for a young person may differ from what is normal for a senior one. That is to say, the concept of health is indeed relative and it is the result of an interesting evolution of the concept of illness. From the first approaches - dealing with the mere treatment of the symptoms - to the promise of a free-from-pain society, science and economics have played a significant role in redefining the dualism health/ illness. The article reflects on these two concepts, health and illness, in history and nowadays, and discusses the future of the medical science

Automatic Artificial Hair Implant: Safety and Efficacy in Androgenetic Alopecia. A Prospective Study with a Highly Biocompatible Fiber

AIM: A multi - centre two years the long prospective open clinical study was conducted in five countries located in four different continents from May 2015 to evaluate the clinical safety and efficacy of Automatic Biofibre hair implant in male and female androgenetic alopecia. Biofibre®is a CE/TGA certified medical grade polyamide fibre suitable for implantation.MATERIAL AND METHODS: A total of 213 patients were enrolled in the study. Patients were assessed pre -operatively by Hamilton scale grading and the percentage of scalp covered by hair. All the patients underwent Biofibre hair implantation by a standardised surgical technique followed by adequate post-operative care. Efficacy of the implant was evaluated by surgeons and patients bimonthly for the first year and trimonthly during the second year. Any adverse effects were recorded during these visits.RESULTS: At the completion of the study period, a total of 194 patients concluded the trial and the results were statistically evaluated. Both Hamilton scale grading and covered area percent improved at the end of the study, and subjective and objective evaluations revealed satisfactory results. Side effects were reported in only 18 cases (9.27%) which were easily controlled by either topical or systemic treatment in 8 to 10 days.CONCLUSION: Overall a successful result was noticed in 97.94% of patients with great psychological satisfaction

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

Psoriasis With Leg Involvement, a New Difficult-to-Treat Area: A Cohort Study of Patients Treated With Risankizumab

Introduction: Historically, difficult-to-treat areas in psoriasis included face, scalp, folds, genitalia, nails and palmoplantar region. Recent studies have found that lower limbs behave like a “new” difficult-to-treat area, as it can be the only site of residual disease even in patients undergoing biologic therapies. Objectives: We aimed to evaluate whether legs had different response rates and response times to treatment with a new biologic drug, risankizumab, than other body sites. Methods: We conducted a real-life, observational, retrospective, multicentric study, including patients affected by moderate-to-severe psoriasis with legs involvement and undergoing biological therapy with risankizumab for more than 16 weeks. The Psoriasis Area Severity Index (PASI) and Leg-PASI were collected at T0 and at week 16, 28, 40, 52, 64 and 76. Statistical analysis using T student test and linear regression analysis were performed. Results: A total of 124 patients were included. The difference between the improvement percentage respect to baseline was statistically significant at week 16 and 28, demonstrating that Leg-PASI improved less than PASI. From the linear regression it was deduced that the slope is statistically less steep for Leg-PASI than for overall PASI, confirming that this site responds more slowly to the therapy. Conclusions: Leg response to risankizumab appears to differ significantly from other body-sites in the first weeks of treatment, even if after 28 weeks statistical significance is lost. Our preliminary finding suggests that risankizumab can be considered an effective treatment for legs psoriasis, but with longer response times than other areas demonstrating the relative nature of resistance to treatment of this district