Black and pink. Single lesion or double diagnosis?

Fibroepithelioma of Pinkus (FeP) is an uncommon skin lesion considered to be a rare variant of basal cell carcinoma (BCC), even though some researchers have argued for its classifica- tion as a trichoblastoma. FeP appears frequently as a solitary, flesh-colored, well-demarcated plaque, typically localized on the lumbosacral area of patients aged 40 to 60 years. It often develops in patients with a history of BCC, most commonly in wome

A review of the literature of surgical and nonsurgical treatments of invasive squamous cells carcinoma

Cutaneous squamous cell carcinoma (cSCC) is an increasing public health problem. It is a primary malignant skin tumor with Malpighian differentiation and together with basal cell carcinoma is classified among nonmelanoma skin cancers (NMSCs). cSCC usually occurs on photoexposed areas, such as the head, the neck, and the extremities, and its incidence increases with age. Invasive forms of this skin tumor tend to be more aggressive showing a higher metastatic potential, usually regarding regional lymph nodes. Treatment options for invasive cSCCs include both surgical and nonsurgical options. The therapeutic choice depends on several factors, such as anatomic location, risk factors for tumor recurrence, age, and health status of the patient. This review aims to provide an overview of the current evidence on therapeutic surgical and nonsurgical management of invasive cSCC

Urticaria in an infant with SARS-CoV-2 positivity

Last months have been marked by the global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 19 (COVID-19) pandemic

IL-17 and its role in inflammatory, autoimmune, and oncological skin diseases. State of art

Recent data support the theory of the involvement of IL-17 in the pathogenesis of several chronic inflammatory skin diseases (psoriasis, atopic dermatitis, acne, hidradenitis suppurativa) and autoimmune skin diseases (alopecia areata, vitiligo, bullous diseases). Even if the role of IL-17 in inflammatory and autoimmune diseases has been reported extensively, its role in tumor is still controversial. Some reports show that Th17 cells eradicate tumors, while others reveal that they promote the initiation and early growth of tumors. Herein, we review the role of IL-17 in the involvement of some common dermatologic diseases: psoriasis, atopic dermatitis, hidradenitis suppurativa, acne, vitiligo, melanoma, and nonmelanoma skin cancers

Therapeutic options for the treatment of actinic keratosis with scalp and face localization

Actinic keratosis (AK) is a common skin disease related to ultraviolet chronic exposure, that is now considered a squamous cell carcinoma in situ. Primary skin cancer prevention strategies should be recommended for high risk patients. There is a wide spectrum of treatment options available for AKs, and several variables should be taken into account regarding the best therapeutic choice for each patient. The purpose of this article is to review the current treatment strategies for AKs localized on the face and scalp, with a focus on the practical point of view that could be useful for choosing the best therapeutic option. The two main therapeutic approaches will be distinguished first: lesion-directed and field-directed. Afterwards, the treatment based on clinical type and patient comorbidity will be discusse

A late onset widespread skin rash in a previous Covid-19 infected patient. Viral or multidrug effect?

In the end of 2019, a series of pneumonia cases emerged in China, with clinical presentations greatly resembling viral pneumonia, caused by Covid-19 o SARS-CoV-2. Currently, several clinicians described an increasingly cases of coronavirus-positive patients reporting skin problems, either in early stage of infection or as late onset manifestation. Recently, Dr. Sebastiano Recalcati analyzed the cutaneous involvement in 148 COVID-19 patients hospitalized in the Lecco Hospital, Lombardy, Italy

Similar levels of efficacy of two different maintenance doses of adalimumab on clinical severity and quality of life of patients with hidradenitis suppurativa

Adalimumab is the only biologic agent approved for the treatment of moderate-to-severe hidradenitis suppurativa (HS) patients (i.e., with Hurley II or III), which is recommended in two different maintenance doses (i.e., 40 mg weekly or 80 mg every two weeks). We conducted a prospective multicentric study to measure outcomes related to the severity of disease and quality of life (QoL) of patients affected by moderate-to-severe HS, treated with adalimumab at a maintenance dosing of 40 mg or 80 mg. Assessments were performed at baseline (T0) and after 32 weeks of treatment (T32). We enrolled 85 moderate-to-severe HS Italian patients, 43 men (50.6%) and 42 women, aged between 16 and 62 years (median 31 years, interquartile range 24.4-43.8). Statistically significant improvements were observed for clinical status (with a mean reduction of 7.1 points for the International Hidradenitis Suppurativa Severity Score System (IHS4)), pain levels (3.1 mean decrease in VAS), and QoL (3.4 mean improvement in DLQI score). Patients with no comorbidities, and those with higher levels of perceived pain showed significantly greater improvement in QoL than their counterpart from T0 to T32. As for the proportion of patients who at follow-up reached the minimal clinical important difference (MCID) in QoL, significantly higher proportions of success were observed for age (patients in the 29-39 category), pain (patients with higher reported pain), and Hurley stage III. While both treatment regimen groups (i.e., 40 vs. 80 mg) improved significantly, no statistical differences were observed when comparing the two treatment dosages

Acne and sun exposure: epidemiology, feelings and behaviours in Mediterranean countries

Background. Acne vulgaris is a common skin disease with a great impact on quality of life.Differences in latitude and sun exposure can totally change the characteristics of the disease. No universally accepted epidemiologic data are currently available. Objective. The aim of this study is to collect epidemiological data about acne, its severi- ty and its management during the summer months in different ethnic groups of the Mediterranean area. Methods. We analysed 355 acne patients (198 Italian, 85 Egyptian and 72 Croatian), between the ages of 12 and 40, and interviewed 80 dermatologists (40 Italian, 20 Egyptian, 20 Croatian) about their habitual therapeutic protocols. A group of expert der- matologists developed a questionnaire for acne patients to gather epidemiologic data and to assess their attitude towards therapy during summertime. Another questionnaire was created for dermatologists, to evaluate their approach to acne management and treat- ment during the summer. Results and discussion. Our results show that summer is an important period for the man- agement of acne in these three countries: a lot of differences in behaviour among patients were registered. Egyptian patients tend to continue therapy during the summer compared to Italian and Croatian patients

The Dermatological Effects and Occupational Impacts of Personal Protective Equipment on a Large Sample of Healthcare Workers During the COVID-19 Pandemic

Introduction: Working during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions. Materials and Methods: An online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables. Results: Two types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38–2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49–2.78, p < 0.001), which acted as risk factors. Discussion: The enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs

Linee guida sulla isotretinoina - consensus

Qualche anno addietro, si sparse la notizia che l'isotretinoina orale sarebbe stata ritirata dal commercio. In quel periodo fu pubblicato sugli Annales de Dermatologie un articolo scritto da un dermatologo francese preoccupato per quanto sarebbe successo a noi dermatologi, privati della isotretinoina orale, nella gestione dei pazienti con acne grave. Si prospettava un quadro di desolante ritorno al passato con \uec pazienti vittime di decisioni amministrative, scientificamente morto discutibili, prese con superficialit\ue0. Fortunatamente questo non accadde vista la infondatezza delle argomentazioni accusatorie avanzate. Da questa vicenda emerse la consapevolezza che alla base di quanto successo c'era una preoccupante disinformazione sulle caratteristiche del farmaco estesa ad ampie fasce di soggetti coinvolti nella gestione e nell'utilizzo del prodotto, medici di medicina generale, pediatri, farmacisti e pazienti. Alla luce di questo abbiamo sentito l'esigenza di colmare questa lacuna e di preparare una nota informativa, chiara e completa, sulle caratteristiche dell'isotretinoina orale. Tale documento era diretto, con modalit\ue0 e contenuti opportunamente adattati, alle singole categorie sopra riportate. L'obiettivo finale era quello di evitare che, a pazienti effettivamente bisognosi di tale trattamento, esso fosse negato con motivazioni inconsistenti o per disinformazione. Il lavoro congiunto di un board di dermatologi, appartenenti alle Societ\ue0 pi\uf9 rappresentative della Dermatologia Italiana, ha portato alla definizione di due documenti informativi sull'isotretinoina orale. Il primo \ue8 indirizzato a medici di medicina generale, pediatri e farmacisti ed il secondo ai pazienti. \uc8 in programmazione per il prossimo futuro la preparazione di linee guida aggiornate sull'utilizzo del farmaco ad uso dei dermatologi