Efficacy of lidocaine 7 %, tetracaine 7 % self-occlusive cream in reducing MAL-cPDT-associated pain in subjects with actinic keratosis: A randomized, single-blind, vehicle-controlled trial (The "3P-Trial")

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Local rhamnosoft, ceramides and L-isoleucine in atopic eczema: A randomized, placebo controlled trial

none8noBackground: A non-steroidal, anti-inflammatory moisturizing cream containing rhamnosoft, ceramides, and L-isoleucine (ILE) (pro-AMP cream) has been recently developed for the specific treatment of atopic eczema (AE) of the face. In this trial, we evaluated the clinical efficacy and tolerability of pro-AMP cream in the treatment of facial AE in children in comparison with an emollient cream. Methods: In a randomized, prospective, assessor-blinded, parallel groups (2:1) controlled trial, 107 children (72 allocated to pro-AMP cream and 35 allocated to control group) with mild-to-moderate chronic AE of the face were enrolled. Treatments were applied twice daily for a 6-week period. Facial Eczema Severity Score (ESS) was evaluated at baseline, week 3, and week 6, by an assessor unaware of treatment allocation. Investigator's Global Assessment (IGA) score was assessed at week 3 and at week 6. Tolerability was evaluated at week 3 and at week 6 using a 4-point score (from 0: low tolerability to 3: very good tolerability). Results: At baseline ESS, mean (SD) was 6.1 (2.4) in the pro-AMP cream group and 5.3 (3) in the control group. In the pro-AMP group, in comparison with baseline, ESS was significantly reduced to 2.5 (-59%) after 3wks and to 1.0 (-84%) at week 6 (p=0.0001). In the control group, ESS was reduced to 3 (-42%) at week 2 and to 2.6 (-50%) at week 6. At week 6, ESS in pro-AMP cream was significantly lower than the control group (1.0 vs. 2.6; p=0.001). Both products were well tolerated. Conclusion: Pro-AMP cream has shown to be effective in the treatment of mild-to-moderate chronic lesion of AE of the face. Clinical efficacy was greater in comparison with an emollient cream. (Clinical trial Registry: NTR4084).Marseglia, Alessia; Licari, Amelia; Agostinis, Fabio; Barcella, Antonio; Bonamonte, Domenico; Puviani, Mario; Milani, Massimo; Marseglia, Gian LuigiMarseglia, Alessia; Licari, Amelia; Agostinis, Fabio; Barcella, Antonio; Bonamonte, Domenico; Puviani, Mario; Milani, Massimo; Marseglia, GIAN LUIG

Caso di Neurofibromatosi diagnosticata a 71 anni

Introduzione: La neurofibromatosi di tipo 1 (NF1) è una malattia genetica a trasmissione autosomica dominante caratterizzata da mutazioni a carico del gene NF1, localizzato sul cromosoma 17q11.2. La sindrome ha un’incidenza di 1 su 3500 ed è caratterizzata da diverse manifestazioni a livello cutaneo, osseo, oculare e nervoso. La diagnosi di NF1 si basa sui criteri clinici che includono macchie caffè-latte, neurofibromi, lentigginosi a livello della regione ascellare o inguinale, glioma del nervo ottico e noduli di Lisch. Dal punto di vista delle funzioni cognitive si possono riscontrare disturbi del linguaggio e ritardo mentale. I pazienti con neurofibromatosi hanno un rischio di sviluppare tumori da 3 a 4 volte maggiore rispetto alla popolazione generale; in particolare, il tumore di Wilms, tumori gastrointestinali stromali (GIST), rabdomiosarcomi, meningiomi, gliomi del nervo ottico e feocromocitomi. Molto raramente la diagnosi clinica e biomolecolare di NF1 viene posta in età avanzata essendo le manifestazioni cliniche della sindrome relativamente precoci e talora presenti fin dalla nascita. Tuttavia, sono riportati in letteratura casi di neurofibromi plessiformi ad esordio molto tardivo. Case Report: Riportiamo il caso di un paziente di 71 anni, ricoverato con la diagnosi di stato di male parziale motorio ed esiti di ematoma cerebrale su base ischemica, che veniva valutato in consulenza dermatologica per il rilievo di numerose lesioni cutanee esofitiche a livello del tronco. Tali lesioni di differente diametro e morfologia erano clinicamente compatibili con la diagnosi di neurofibromi, che veniva confermata successivamente all’esame istologico. Il paziente si mostrava poco collaborante e scarsamente orientato nel tempo e nello spazio. All’esame obiettivo venivano rilevate, inoltre, lentiggini ascellari bilaterali, numerose chiazze caffè-latte, scoliosi ed ipoacusia bilaterale. L’anamnesi familiare era negativa per il rilievo di neurofibromi e altri segni riconducibili a tale patologia. Attualmente è in corso lo studio genetico per la ricerca mutazionale a carico del gene NF1. Conclusioni: La diagnosi tardiva di NF1 nel paziente che presentiamo può essere addotta in parte alla comparsa in età avanzata del fenotipo cutaneo ed in parte al disagiato contesto familiare che non ha contribuito all’attuazione di adeguate strategie diagnostiche e di follow-up clinico-strumentale. Tale caso clinico ci rammenta che la diagnosi di Neurofibromatosi può essere posta anche in pazienti con anamnesi familiare completamente negativa per la comparsa di mutazioni de novo. E’ noto che il 50% dei pazienti con diagnosi di NF1 non presenta storia familiare per tale patologia

In Vivo Melanoma Cell Morphology Reflects Molecular Signature and Tumor Aggressiveness

Melanoma is the deadliest type of skin cancer, characterized by high cellular heterogeneity which contributes to therapy resistance and unpredictable disease outcome. Recently, by correlating Reflectance-Confocal-Microscopy (RCM) morphology with histopathological type, we identified four distinct melanoma-subtypes: dendritic-cell (DC), round-cell (RC), dermal-nest (DN), and combined-type (CT) melanomas. In the present study, each RCM-melanoma subtype expressed a specific biomolecular profile and biological behavior in vitro. Markers of tumor aggressiveness, including Ki67, MERTK, nestin and stemness markers, were highest in the most invasive CT and DN melanomas, as compared to DC and RC. This was also confirmed in multicellular tumor spheroids. Transcriptomic analysis showed a modulation of cancer progression-associated genes from DC to CT melanomas. The switch from E- to N-cadherin expression proved the epithelial-to-mesenchymal transition from DC to CT subtypes. The DN melanoma was predominantly located in the dermis, as also shown in skin reconstructs. It displayed a unique behavior and a molecular profile associated with a high degree of aggressiveness. Altogether, our results demonstrate that each RCM-melanoma subtype has a distinct biological and gene expression profile, related to tumor aggressiveness, confirming that RCM can be a dependable tool for in vivo detecting different types of melanoma and for early diagnostic screening

Efficacy and Skin Microbiome Modulation Effects of a Fixed-Concentration Combination of Benzoyl Peroxide 4% Plus Niacinamide 4% in a Film-Forming Cream in Subjects with Mild-to-Moderate Acne: A Non-Sponsored, Prospective, Assessor-Blinded, Pilot Trial

Benzoyl peroxide (BPO) and niacinamide (Niac) are commonly used alone or in combination with other molecules in the treatment of acne. BPO and Niac in the same product could exert complementary and synergistic effects improving efficacy in acne. Furthermore, Niac could reduce some side effects of BPO, such as skin irritation and erythema. A film-forming cream product containing BPO 4% and Niac 4%, vehiculated in a mixture of polyvinyl alcohol (PVA) and perfluoropolyether (PFPE) has been recently developed (B-N cream). A 28-day, assessor-blinded pilot trial was conducted to evaluate the clinical efficacy, skin tolerability, sebum production, skin redness, and skin microbiome modulation of B-N cream in subjects with mild to moderate acne of the face. Twenty-two adult men and women with mild-to-moderate acne of the face participated in this trial, after their written informed consent. B-N cream was applied once daily in the evening. The use of B-N cream was associated with a statistically significant decrease in acne lesions after treatment in comparison with baseline (non-inflammatory lesions: −40%; inflammatory lesions: −43% and total lesions: −41%). The use of the cream was not associated with a skin barrier function alteration. The skin redness score (−11%) and the sebum production (−42%) were significantly reduced after treatment. The use of B-N cream determined a reduction in the relative abundance of the Actinobacteria phylum (Corynebacterium and Propionibacterium, from 56% to 47%) and a significant increase in the abundance of Bacteroidetes phylum (from 3% to 5.2%). In addition, the product was well tolerated. In conclusion, this film-forming, medical device cream was effective in subjects with mild-to-moderate acne, reducing acne lesions and sebum production without altering skin barrier function, offering good skin tolerability. Furthermore, this product exerts positive skin microbiome modulation effects

Anti-Aging Efficacy of Melatonin-Based Cream: Clinical and Instrumental Skin Evaluation

Melatonin is a potent mitochondrial, cytoprotective and antioxidant molecule with potentially strong anti-aging properties. Topical melatonin has been shown to improve the clinical signs of skin aging. Melatosphere™ is a new lipid-based delivery system able to improve stability and skin penetration of melatonin when used in topical formulations. No clinical studies, using objective instrumental data, are available so far regarding the positive effect of Melatosphere™ in improving wrinkles in women with mild to moderate skin aging. In an open prospective, evaluator-blinded trial, we evaluate the effects on skin texture of two months of treatment with a Melatosphere™-based cream. Fifteen women aged >45 years with mild to moderate facial skin aging (Glogau score 2–4) participated in the trial, after providing their informed consent. An ANTERA 3D computer-assisted skin analysis evaluation for the assessment of coarse and fine wrinkles of the periorbital area and melanin content was performed at baseline and after two months of treatment. An evaluator-blinded Investigator Global Assessment (IGA) of skin elastosis, roughness, level of dyschromia, skin dryness and the presence of actinic damage was also performed at the same time points using a four-grade score from 0 (no sign) to 3 (severe sign). At baseline, the mean (SD) IGA score was 8.2 (1.0). After two months, the IGA score significantly decreased to 4.2 (1.4) (49% reduction) (p = 0.0007). ANTERA 3D evaluations showed a significant reduction in the coarse and fine wrinkle volume in the target area of −31% and −18%, respectively. Melanin content was reduced significantly by −17%. Topical melatonin carried in Melatosphere™ improves, in the short term, signs of skin aging evaluated clinically and using the ANTERA 3D device in women with mild to moderate skin aging

Treatment of Grade II and III Actinic Keratosis Lesions with a Film Forming Medical Device Containing Sunscreen/Piroxicam 0.8% and a Retinoic acid/Glycolic Gel: A Pilot Trial

<p></p><p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>. </b><a href="https://link.springer.com/article/10.1007/s13555-018-0244-3">https://link.springer.com/article/10.1007/s13555-018-0244-3</a></p><p></p><p></p><p> </p><p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p><br><p></p

<em>Hypericum perforatum</em> and <em>Azadirachta indica</em> (Neem) oil in the management of chronic leg ulcers: An uncontrolled retrospective observational case review

Chronic nonhealing leg ulcers are debilitating with high morbidity in a vulnerable patient population and pose a frequent clinical and socioeconomic problem. Numerous local treatment options exist, but clinical trials are rare and wound management still represents a big challenge. Recently a wound dressing based on the natural remedies Hypericum perforatum and Neem oil has been proposed for chronic wound management, but trials on nonhealing leg ulcers are missing. Uncontrolled retrospective observational case review on all patients under our supervision with chronic leg ulcers who underwent treatment with a plant-derived wound dressing based on Hypericum perforatum and Azadirachta indica (Neem) oil. It could be retrieved in a total 16 cases (11 female) with a median age of 71 years. All ulcers (7 ulcers on the leg and 9 ulcers on the feed) showed a complete healing after a median healing time of 82 days (Mean 85, range 14-180 days). No side effects occurred, medication was painless or even reduced pain. Wound dressings based on Hypericum perforatum and Neem oil are well tolerated and could be a potential additional simple treatment option in the management of non-healing leg ulcers. Prospective controlled trials are needed to confirm these observations