Fotodermatosi

Le fotodermatosi in età pediatrica rappresentano un vasto capitolo delle patologie dermatologiche. La luce solare è in grado di produrre malattie caratterizzate da fotosensibilità. Il capitolo focalizza l'attezione soprattutto su le fotodermatosi autoimmuni e quelle mediate da sostanze chimiche. Fra le prime vengono trattate soprattutto la dermatite polimorfa solare, l'orticaria solare e l'hydroa vacciniforme; fra le seconde la gran parte è rappresentata da reazioni fototossiche a vegetali (fitofotodermatiti, cosmetici e farmaci sia topici che sistemici

Topical nicotinamide for seborrheic dermatitis: an open randomized study.

Background: Treatment of seborrheic dermatitis (SD) includes various options with different success and safety limitations. Objective: To evaluate the efficacy of topical nicotinamide (NCT) in the treatment of SD. Methods: A total of 48 patients with mild to moderate SD of the face were enrolled in the study (36 males and 12 females; age 20-50 years). Patients were randomized into two groups A and B, who were treated once a day with topical administration of NCT 4% cream and with the vehicle without NCT (placebo), respectively. Clinical measures were assessed by erythema, scaling, and infiltration, which were evaluated using a four-point scale 0-3 before starting treatment and after 2, 6, and 12 weeks' therapy. Results: In comparison with baseline, a reduction of 75% of the total score was observed in patients treated with NCT, whereas for placebo-treated patients the reduction was of 35% (p < 0.05). Conclusion: Topical NCT 4% can have a potential for the treatment of SD

Solar urticaria in the visible spectrum successfully treated with astemizole

Three cases of solar urticaria in the visible spectrum successfully treated with astemizole, a H1 antihistamine, are reported. The administration of 10 mg a day of the drug increased the minimal urticarial dose from 2 to 12 times

Does postoperative radiation therapy represent a contraindication to expander-implant based immediate breast reconstruction? An update 2012-2014

Post-mastectomy radiotherapy (PMRT) is well known in the plastic surgery community for having a negative impact on expander-implant based immediate breast reconstruction (IBBR), although recently some technical improvements allow better results. Very recent papers would suggest that there is no difference in postoperative complications in patients receiving post-mastectomy radiotherapy using modern techniques. However, study results are often biased by small groups of patients and by heterogeneity of radiotherapy timing, different surgical techniques and measured outcomes

Lichen amyloidosus: a new therapeutic approach.

The result of topical treatment by dimethyl sulphoxide (DMSO) in a patient with lichen amyloidosus is reported. Itching improved within five days of therapy. Remarkable flattening of the papules was obtained within two weeks. The clinical result was confirmed by histological examination which revealed partially disappearance of amyloid deposits

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

UV-selective face cream (Acne RA-1,2) in acne patients: clinical study of effects on epidermal barrier function, sebum production, tolerability and adherence to pharmacological therapy.

BACKGROUND: General skin care recommendations such as the use of moisturisers and products with adequate photoprotection are important components of management for acne patients to complement the medical regimen. This study aimed to evaluate the real-life clinical effects of a novel UV-selective face cream (Acne RA-1,2) on acne, epidermal barrier function, sebum production, adherence and tolerability when used together with pharmacological acne treatment. METHODS: 40 patients receiving pharmacological acne treatment applied Acne RA- 1,2 once-daily for 3 months. Investigator's Global Assessment of acne, trans- epidermal water loss, sebum production and tolerability were assessed after 1 and 3 months. RESULTS: After 3 months, there was a 38% significant clinical improvement in mean Investigator Global Assessment score (3.4 to 2.1), a 29% significant reduction in trans-epidermal water loss (13.2 to 9.4 g/h/m2), and a 17% significant decrease in sebum production vs baseline (234.6 to 195.6 μg/cm2; all p<0.01). 100% of patients reported complete adherence to pharmacological therapy over the summer of the study vs 52.5% in the previous summer. 87.5% considered their acne improved over the summer of the study vs 55.0% in the previous summer. Pruritus, erythema, dryness and total tolerability symptom scores were significantly reduced after 3 months vs baseline (p<0.05). CONCLUSIONS: Acne RA-1,2 is a useful daily adjunct to pharmacological therapy as it helps to mitigate the irritation these therapies cause, increasing adherence to therapy, and leading to a clinical improvement in acne and epidermal barrier function and a decrease in sebum productio

Photodynamic therapy: a treatment tool for hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating inflammatory disease of unknown aetiology. The current standard of care for HS includes antibiotics (oral/topical), retinoids (oral/topical) and intralesional steroids. However, the recurrence of the disease and the unsuccessful of the different treatments stimulate findings of different therapy using light source. Among these, photodynamic therapy with 5-aminolevulinic acid (ALA-PDT) has been proposed by some authors recently. In this study we report the experience of 15 patients affected by HS resistant to conventional therapy treated with ALA-PDT

Vitiligo, NB-UVB and tacrolimus: our experience in Naples.

Aim: The aim of the present study was to evaluate the efficacy and safety of narrowband UVB (NB-UVB) compared with tacrolimus ointment 0.1% in patients with bilateral vitiligo. Methods: In this comparative study, four groups of patients were randomized. Each group was composed by 12 patients with bilateral vitiligo; in each group, every patient was irradiated with NB-UVB (length: 311 nm) twice a week for 9 months and applied tacrolimus ointment 0.1% twice a day on the other area in the same period. Before starting therapy and after 3, 6 and 9 months of therapy, a clinical and photographic evaluation of percentage of repigmentation was performed and Dermatology Life Quality Index Questionnaire was fulfilled. Results: A repigmentation at least partial occurred in 71% of patients after 36 weeks of treatment with tacrolimus ointment 0.1%; in the whole sample, 14 patients (29%) showed no repigmentation at all, with 2 of them discontinuing the therapy because of side effects (erythema and folliculitis-like manifestations). A homogeneous repigmentation at least partial occurred in 69% of patients after 36 weeks of treatment with NB-UVB; in the whole sample 15 patients (31%) showed no repigmentation at all, with 1 of them discontinuing the therapy because of side effects. Conclusion: The present study confirmed that the efficacy of NB-UVB phototherapy in vitiligo is comparable to tacrolimus ointment 0.1% therapy. On the basis of our study, we may suggest tacrolimus ointment 0.1% as an alternative to NB-UVB therapy for treating vitiligo

TRATTAMENTO ASSOCIATO UVB-DITRANOLO IN PAZIENTI CON PSORIASI A PLACCHE

The purpose of this study was to determine whether the combination of ultraviolet B therapy and anthralin would result in a more rapid resolution of plaque-type psoriasis. Short-contact anthralin (0.5% in petrolatum) was used. Ultraviolet B irradiation was carried out 5 times a week with a bank of 8 Philips TL 40W/12 tubes (irradiance, 1 mW/cm2 30 cm). Out of the 14 patients studied, seven (group I) were given anthralin for 15 days before practicing UVB therapy and seven (group II) carried out phototherapy sessions for 15 days before the combination of both treatments. These results show both a more rapid clearance of psoriatic plaques and lower UVB total dose with anthralin pretreatment