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

Epiluminescence microscopy for port-wine staine pretreatment evaluation.

Background: Port-wine stains (PWSs) are characterized by an increased number of ectatic vessels. The treatment of choice is the use of some lasers such as pulsed dye lasers. However, some lesions are nonresponsive to laser treatment. Perhaps the vessels' depth and diameter and the thickness of the vessel wall are important factors influencing the effectiveness of the laser treatment. Methods: To investigate whether epiluminescence microscopy (ELM) could be useful in determining the effectiveness of laser treatment of PWSs, we studied a group of patients with PWSs using both ELM and histological analysis. Results: A correlation existed between a gray-whitish veil seen by ELM and the vessel depth judged by histology: when the veil was absent, the vessels were always found to be located only in the upper third of the dermis. Conclusion: We think that the gray-whitish veil is a distinctive dermoscopic feature that is able to differentiate between superficial vessels (absence of veil) and deeper vessels (presence of veil)

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

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

A reappraisal of the biological functions of melanins and melanogens: The role of 5,6-dihydroxyindole-2-carboxylic acid (DHICA) in skin (photo)protection

Solar ultraviolet rays (UVR) play an important role in melanoma and non-melanoma skin cancer development while melanins, produced by melanocytes, are involved in photoprotection, control of oxidative stress, regulation of skin homeostasis and immunity. The ratio between the two main groups of melanin, eumelanins and pheomelanins, is regulated by the mc1r gene encoding for melanocortin-1-receptor (MC1R), whose inactivation causes a switch from eumelanin to pheomelanin production. While eumelanins are considered to be photoprotective, pheomelanins are known to be (photo)toxic as they lead to the production of reactive oxygen species in the presence and in the absence of UV radiation. It seems that not only eumelanins but even their precursors can contribute to the (photo)protective action. In particular, 5,6-dihydroxyindole-2-carboxylic acid (DHICA) and its main metabolite 6-hydroxy-5- methoxyindole-2-carboxylic acid (6H5MICA) have antioxidant properties so they could play a critical role in the responses of the melanocyte to oxidative stress and inflammation. Moreover, it has been showed that DHICA is able to act as a chemical messenger inducing antioxidant defense systems and cell differentiation in keratinocytes. On these basis, DHICA and its methylated metabolite could play an important role in chemopreventive strategies of melanoma skin cancer

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

Acne Smart Club: An Educational Program for Patients with Acne

Objective: To evaluate adherence to therapy in acne patients using mobile phones and Short Message Service (SMS) to communicate. Methods: 160 patients were randomly assigned to two groups: the SMS group received 2 text messages twice a day for a period of 12 weeks; the control group did not receive any messages. Before and after 12 weeks, the following evaluations were performed in all patients: digital photographs, the Global Acne Grading System, the Dermatology Life Quality Index, the Cardiff Acne Disability Index, the doctor-patient relationship evaluated through the Patient-Doctor Depth-of-Relationship Scale, and the adherence to treatment evaluated by asking patients how many days a week they had followed the therapy. For statistical analysis we used Student's t test. Results: The SMS group had a better improvement of all parameters compared to the control group. Conclusion: Adherence and compliance are higher for patients who are included in a strategy of control. © 2014 S. Karger AG, Basel

Polymorphous light eruption and benign summer light eruption

BACKGROUND/PURPOSE: Polymorphous light eruption (PLE) heterogeneity has been postulated, but the existence of benign summer light eruption (BSLE) is controversial. We studied the prevalence of the clinical patterns, criteria distinguishing BSLE from PLE, and diagnostic usefulness of phototest. METHODS: Five Italian Photodermatology Centres recruited retrospectively 346 patients with typical clinical history and/or presentation of PLE. Age, gender, skin type, family history and presence of atopy were considered. UVA and UVB MEDs and provocative phototests with UVA and UVB were obtained with a standardized procedure. Photopatch tests were applied according to the IRCDG rules. ANA were assessed by indirect immunofluorescence. RESULTS: Four criteria (predominance of women, shorter latency, uninvolvement of the face and absence of relapse during summer) identified BSLE in only 6.1% of cases. All had positive phototests, mostly with UVA. Uninvolvement of face, short latency and no seasonal relapses identified 11.7% patients, mostly with positive phototests to UVA. Short latency and no seasonal relapses in women identified 11.2% patients. Uninvolvement of face and no seasonal relapses in women identified 8.1% of patients. Uninvolvement of face and short latency in women identified 17.6% of patients. CONCLUSION: Criteria diagnosed BSLE in only a minority of patients, who were positive at phototesting, mostly with UVA

Bullosis diabeticorum: a case report.

A case of an unusual bullous eruption (bullosis diabeticorum) occurring in a diabetic is reported. Clinical and histological features and possible pathogenetic mechanisms are discussed