Eyelid skin metastasis as first sign of breast cancer recurrence.

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New formulation for topical treatment of onychomycoses

BACKGROUND: In order to treat onychomycosis, topical and systemic medications are available. The choice of a systemic or topic treatment depends on numerous factors, such as patient's age, the presence of comorbidity, responsible fungal species, the clinical form of onychomycosis, its location (fingernails or toenails), the number of nails affected and the percentage of the nail plate infected. As for topical medications, given that nail plate has an insufficiently permeable structure, it is necessary to use appropriate formulae that create in the surface of the nail plate a film able, in turn, to function both as an active ingredient's deposit and moisturising agent in nail's superficial layers in order to facilitate the spread of the active ingredient. In this manuscript, we wanted to evaluate the effectiveness and tolerability rate of a new topical formulation (Miconal Nails®, Morgan srl, Vicenza, Italy) composed of hydrogenated castor oil, hydroxyethyl cellulose, and other ingredients (urea, climbazole, piroctone olamine, undecylenic acid). METHODS: We selected 25 patients of both sexes whose median age was between 20 and 70 years, and were affected by onychomycosis in a single toe. Their onychomycosis was a distolateral subungual type (with a <50% invasion of nail plate and sparing of lunula) and white superficial. The treatment was evaluated with the following possible outcomes: Complete healing, improvement, stationarity, worsening. RESULT S: Patients were 11 female subjects and 14 male subjects, whose median age was 45. A complete healing was achieved in 15 patients. In 3 cases the clinical presentation appeared unchanged with a persistence of mycological evidence. The response to the treatment was assessed as improvement in 7 patients. CONCLUSIONS: In our experience, this new product is an effective weapon that enhances the therapeutic selection of topical formulae for treating onychomycosis. If used alone in the cases that meet inclusion criteria for topical treatment, it allowed us to achieve a complete healing just with a 5-month treatment in 60% of cases, data that reached 76% on the follow-up visit

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

Melanoma and pregnancy

T he last decades were characterized by a worldwide increasing incidence in melanoma. Almost 35% of diagnosed with melanoma women are in childbearing age. Malignant melanoma is the most common malignancy during pregnancy. Considering this background it is clear how melanoma and pregnancy has becoming one of the main topic of discussion. Current knowledge about pregnancy and melanoma is characterized by many controversies and divergences. The real incidence of melanoma in childbearing and the impact of pregnancy on the prognosis of melanoma is still unclear. There are many uncertainties regarding other aspects of women with melanoma during childbearing, such as the changing in moles, the prognosis and the management. Every changing nevus that would raise concern for malignancy in a pregnant patient should be investigated and surgery should be performed safely using local anesthetic. Pregnancy can affect the staging and treatment of melanoma especially in advanced stage, the decision about introduction or continuation of treatment in the event of pregnancy should be preceded by an analysis of the potential benefits and risks. The role of hormonal changes during pregnancy on melanoma is continually debated. At present, there is a lack of a European guideline on this topic and this review aims to address the most controversial issues such as the roles of hormones, staging and therapeutic difficulties of melanoma during pregnancy. The authors' aim is to help the clinician in the difficult decision-making process concerning the woman suffering from melanoma and her child

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

In-transit melanoma metastases

In-transit (IT) metastases refer to cutaneous or subcutaneous melanoma spread or recurrence, more than 2 cm away from the primary tumor but not beyond the draining regional lymph nodes. IT metastases treatment is challenging, owing to a wide range of clinical presentations, and the overall prognosis is quite poor (the 5-year survival ranges between 20 and 60%), since their appearance preludes systemic involvemen

Comment on Katsarelias, D., et al. “The Effect of Beta-Adrenergic Blocking Agents in Cutaneous Melanoma—A Nation-Wide Swedish Population-Based Retrospective Register Study” Cancers 2020, 12, 3228

We read the paper by Katsarelias et al. with great interest, regarding the effect of beta-adrenergic blocking agents on cutaneous melanoma [1]. However, the study presents some methodology biases that do not allow us to support the authors&rsquo; conclusions. The paper suffers from the unification and evaluation of multiple registries, which do not provide essential data for any of the targets for research. Unlike studies in the literature [...

The impact of body area in melanoma self-detection

To assess the patient's capability of performing a correct skin-check examination we investigated the association of melanoma detection pattern with Breslow thickness, by melanoma body area. In this prospective observational study, patients with primary cutaneous melanoma who presented at the Department of Dermatology at the University of Florence between January 2000 and November 2011 were interviewed as part of their clinical data recording procedure at the time of their final histopathological diagnoses of melanoma. With the aim of evaluating a self skin-check, we included patients with melanoma in the anterior part of the trunk (abdomen and chest area), which is generally considered visible in the mirror, and the posterior part of the trunk, which is a more complex area to be self-checked. The treating physician specifically questioned all patients about who had first detected or suspected the lesion that resulted in the histological diagnosis of melanoma in order to compare those who had self-detected (SD) their melanoma with those who had discovered their melanoma during a regular skin-check (RSC) with a dermatologist. A total of 186 melanoma patients were analyzed, with 67% (n=125) of melanomas located on the back and 33% (n=61) in the chest and abdominal area; the majority (55%, n=103) were in the SD group. The median Breslow thickness of the SD group was significantly greater than that of the RSC group: 0.60 versus 0.50 mm (P<0.0001). In the posterior trunk, the frequency of thick melanomas (Breslowâ¥1.00 mm) was significantly greater in the SD group than in the RSC group (34 vs. 11%; P=0.003), whereas there was no difference in the frequency of thick melanoma by detection patterns in the anterior trunk. Given the influence of the body area in detecting threatening melanoma, we should encourage people to obtain dermatological skin-checks more often. Skin self-examinations cannot be sufficiently accurate

Cutaneous Metastasis from Breast Tumour Seeding in Percutaneous Needle Biopsy

Viene presentato un caso clinico di metastasi cutanee da carcinoma mammario in seguito ad agobiopsi

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