Mechanical Stress as a Cause of Hidradenitis Suppurativa: A Lesson from a Patient with a Monster Hernia

No abstract available </p

Misdiagnosed atopic dermatitis: Case report

We report a case of a healthy 12-year-old female, who presented a large eczema of the face for more than 2 months. After microbiologic examination a diagnosis of atopic dermatitis with Staphylococcus aureus colonization was done. A combined topical corticosteroid- oral antibiotics therapy allowed to obtain a good clinical response. There was no recurrence 6 months after the treatment. Our case highlights that sometimes staphylococcal skin infections affecting atopic dermatitis can lead to misdiagnosis

Mechanical Stress as a Cause of Hidradenitis Suppurativa: A Lesson from a Patient with a Monster Hernia

No abstract available </p

Salicylic acid for the treatment of melasma: new acquisitions for monitoring the clinical improvement.

OBJECTIVE: The Melasma Area and Severity Index (MASI) and the Melasma Severity Score (MSS) are calculated on the basis of only a subjective clinical assessment. This raises the need to have an objective score, uniform in the evaluation by different clinicians. The purpose of this study was to establish if the images by Canfield Reveal Imager can be correlated to MASI score to better evaluate the clinical efficacy of salicylic acid 33% peeling in the treatment of melasma respect to the clinical observation. METHODS: The study was a voluntary observational study. Twenty female patients affected with melasma, aged between 30 and 60 years, were included in the study. Treatment with salicylic acid 33% was performed once a month, for a total of four times. The dermatologist (Doc A) examined each patient's melasma areas using MASI score, at the face-to-face observation and at Reveal images evaluation during the first (T0) and the end point time (T4). Digital photographs were also evaluated by another experienced dermatologist (Doc B), who has never seen clinically the patients before and who evaluated MASI score by Reveal images at time T0 and T4. RESULTS: Student's t-test and linear regression test were performed, showing statistically significant values comparing MASI score obtained by digital photo and MASI score obtained clinically. CONCLUSION: The monitoring of the improvement by Reveal images can optimize the treatment approach and the efficacy of same dermocosmetics procedures can be revised following standard criteria

The effect of aminolevulinic acid photodynamic therapy on microcomedones and macrocomedones

Background: Photodynamic therapy (PDT) with aminolevulinic acid (ALA) has been shown to be an effective treatment for acne. However, the effect of ALA PDT on comedo formation has never been objectively evaluated. Cyanoacrylate follicular biopsy (CFB), a noninvasive procedure, has been proposed as the most reliable tool for studying follicular casts. Objective: To determine the possible effect of ALA and red light (550-700 nm) on macro- and microcomedones in acne patients. Patients and Methods: 10 patients with mild-to-moderate facial and/or chest/back acne resistant to conventional therapies received ALA PDT at 2-week intervals in 3 sessions. The severity of acne had been estimated by a system of points, the Global Acne Grading System. The patients underwent PDT utilizing ALA 10% (face) or 15% (back/chest) and red light (15 J/cm2 each session). CFBs were performed. Results: Four weeks after their last PDT session, the patients showed an average global score reduction of 50%. CFBs demonstrated a reduction in the total area, the average area and the density of macrocomedones. Conclusion: The results obtained in this study using CFB evaluation demonstrate that ALA PDT exerts an action on the comedogenic phase as well

Percutaneous collagen induction: An effective and safe treatment for post-acne scarring in different skin phototypes

Background: Atrophic scars can complicate moderate and severe acne. There are, at present, several modalities of treatment with different results. Percutaneous collagen induction (PCI) has recently been proposed as a simple and effective therapeutic option for the management of atrophic scars. Objective:The aim of our study was to analyze the efficacy and safety of percutaneous collagen induction for the treatment of acne scarring in different skin phototypes. Methods & materials: A total of 60 patients of skin types phototype I to VI were included in the study. They were divided into three groups before beginning treatment: Group A (phototypes I to II), Group B (phototypes III to V), and Group C (phototypes VI). Each patient had three treatments at monthly intervals. The aesthetic improvement was evaluated by using a Global Aesthetic Improvement Scale (GAIS), and analyzed statistically by computerized image analysis of the patients' photographs. The differences in the GAIS scores in the different time-points of each group were found using the Wilcoxon's test for nonparametric-dependent continuous variables. Computerized image analysis of silicone replicas was used to quantify the irregularity of the surface micro-relief with Fast Fourier Transformation (FFT); average values of gray were obtained along the x- and y-axes. The calculated indexes were the integrals of areas arising from the distribution of pixels along the axes. Results:All patients completed the study. The Wilcoxon's test for nonparametric-dependent continuous variables showed a statistically significant (p < 0.05) reduction in severity grade of acne scars at T5 compared to baseline (T1). The analysis of the surface micro-relief performed on skin replicas showed a decrease in the degree of irregularity of skin texture in all three groups of patients, with an average reduction of 31% in both axes after three sessions. No short- or long-term dyschromia was observed. Conclusion: PCI offers a simple and safe modality to improve the appearance of acne scars without risk of dyspigmentation in patient of all skin types. © 2014 Informa Healthcare USA on behalf of Informa UK Ltd

Statistical techniques applied to the automatic diagnosis of dermoscopic images

An image based system implementing a well‐known diagnostic method is disclosed for the automatic detection of melanomas as support to clinicians. The software procedure is able to recognize automatically the skin lesion within the digital image, measure morphological and chromatic parameters, carry out a suitable classification for the detection of structural dermoscopic criteria provided by the 7‐Point Check. Original contribution is referred to advanced statistical techniques, which are introduced at different stages of the image processing, including the border detection, the extraction of low‐level features and scoring of high order features (namely dermoscopic criteria). The proposed approach is experimentally tested with reference to a large image set of pigmented lesions

The use of skin needling for the delivery of a eutectic mixture of local anesthetics

AIM: The use of skin needling is believed to aid the transdermal delivery of drugs, even if it is mostly used for skin collagen induction. The aim of this paper was to use skin needling, combined with a local anesthetic EMLA (eutectic mixture of lidocaine and prilocaine), as a way to enhance transdermal drug penetration and optimize the analgesic effects of common local anesthesia. METHODS: We recruited 15 patients. For each patient of our study we defined a skin area of 3 cm2 from two forearms: on one side, we used skin needling first and immediately thereafter applied the EMLA in occlusion for 60 minutes; on the other one, we only applied EMLA in occlusion for 60 minutes. Then, pain was induced in each patient's forearm by introducing a 27 G needle into the skin 4 mm deep three times. Lastly, pain sensation measures were registered and a middle value was calculated. RESULTS: When skin needling is used in conjunction with EMLA applied in occlusion for 60 minutes on skin forearms, the level of pain sensation registered was significantly reduced on a Visual Analogue Scale compared to the application of EMLA alone. CONCLUSION: The use of skin needling can improve the transdermal delivery of an emulsion-like eutectic mixture of local anesthetics (EMLA) and can introduce the use of this method for delivering topical molecules in dermatology

Tyndall discoloration and filler injections: A possible side effect

One of the possible side effects that may occurred after injection of hyaluronic acid (HA) filler substances is the appearance of blue-grey discoloration of the skin in the site of injection due to the so called Tyndall effect. In this brief case report, we describe such adverse reaction occurred in a 48 years old female patient and its treatment

Aesthetic procedures side effects: Nodules and long lasting oedema in filler implantation

Side effects can occur after hyaluronic acid (HA) fillers injection. In this brief report, we present 5 cases of fillers injection's side effects: 4 patients with persistent nodules after HA injection into glabella, nasolabial folds, lips, and infraorbital area and 1 patient with long lasting oedema of the lip