Hypopigmented macules of the limbs in two sisters: Report on familial bier spots

Bier spots are asymptomatic, small, irregular, hypopigmented macules characterized by a normal histological appearance, which are usually found on the arms and legs of young adults. We describe the simultaneous presence of Bier spots in two siblings. This finding is unusual since, to the best of our knowledge, concurrent familial cases have never been reported in the literature

Lichen striatus associated with psoriasis vulgaris treated with oral acitretin.

Lichen striatus (LS) is an uncommon dermatosis of unknown etiology that presents as a continuous or interrupted linear band of pink, tan, red or skin-colored papules in a blaschkoid distribution. The lesions are generally solitary and unilateral, but unusual extensive cases with multiple and bilateral lesions have been also described. Albeit LS is typically an asymptomatic and self-limited dermatosis, it may cause a significant psychological distress in some patients, thus requiring an appropriate therapy. Topical steroid is the most commonly used treatment but it is not always effective. We report a case of LS unresponsive to topical steroid therapy associated with psoriasis vulgaris successfully treated with oral acitretin

Annular elastolytic giant cell granuloma treated with topical pimecrolimus.

4openopenErrichetti E; Stinco G; Avellini C; Patrone P.Errichetti, E; Stinco, Giuseppe; Avellini, C; Patrone, Pasqual

Clinical Features of 705 Borrelia burgdorferi Seropositive Patients in an Endemic Area of Northern Italy

Background. Lyme Borreliosis is a multisystemic infection caused by spirochetes of Borrelia burgdorferi sensu lato complex. The features of Lyme Borreliosis may differ in the various geographical areas, primarily between the manifestations found in America and those found in Europe and Asia. Objective. to describe the clinical features of Lyme Borreliosis in an endemic geographic area such as Friuli-Venezia Giulia in the Northeastern part of Italy. Methods.The medical records of patients resulted seropositive for Borrelia burgdorferi have been retrospectively recorded and analyzed. Results. Seven hundred and five patients met the inclusion criteria, 363 males and 342 females. Erythema migrans was the most common manifestation, detected in 437 patients. Other classical cutaneous manifestations included 58 cases of multiple erythema migrans, 7 lymphadenosis benigna cutis, and 18 acrodermatitis chronica atrophicans. The musculoskeletal system was involved in 511 patients. Four hundred and sixty patients presented a neurological involvement. Flu-like symptoms preceded or accompanied or were the only clinical feature in 119 patients. Comments.The manifestations of Lyme borreliosis recorded in this study are similar to the ones of other endemic areas in Europe, even if there are some peculiar features which are different from those reported in Northern Europe and in the USA

Acrodermatitis chronica atrophicans of the face: a case report and a brief review of the literature.

Acrodermatitis chronica atrophicans is a rare late manifestation of tick-borne Borrelia burgdorferi infection, manifesting as inflammatory and atrophic lesions on acral skin.We describe the case of  a 73-year-old woman with skin changes progressed to marked atrophy on her left hand and an edematous inflammatory involvement of the face. The diagnosis of acrodermatitis chronica atrophicans was made on the basis of clinical appearance, serological and histopathological findings, and the lesional detection of B. burgdorferi-specific gene segments by polymerase chain reaction.This unusual case illustrates that acrodermatitis chronica atrophicans affects not only the extremities but also the face. The clinical and histological finding of the lesions occurring on acral skin showed a prominent atrophic appearance, while the ones occurring on the face showed a prominent inflammatory appearance..</p

Clinical and Capillaroscopic Modifications of the Psoriatic Plaque during Therapy: Observations with Oral Acitretin

Psoriasis is considered to be an inflammatory autoimmune disease, where angiogenesis plays an undefined pathogenetic role. The well-known changes of the superficial microvasculature in the psoriatic plaque can be easily assessed in vivo by videocapillaroscopy. In the last years, several studies reported the clinical and capillaroscopic response of the psoriatic plaque during different topical and systemic treatments. In the present work we evaluated the effects of acitretin (0.8 mg/kg/day) on videocapillaroscopic alterations and the clinical response in 11 patients affected by plaque psoriasis at the baseline (T0) and after 4 (T1), 8 (T2), and 12 (T3) weeks. A clinical improvement during the treatment with a complete clinical healing of the plaque in 7 of the 11 patients was observed. The typical “basket-weave” capillaries of the psoriatic lesions showed a reduction of 65.4% in diameter at the end of the study; only 3 patients returned to a normal capillaroscopic pattern. As observed during previous our studies, we found a discrepancy between clinical and capillaroscopic results, with a far greater improvement in the first than in the second. This finding could be in agreement with a secondary role of blood vessels in the pathogenesis and persistence of psoriatic lesions

Pruritus in chronic plaque psoriasis: a questionnaire-based study on 230 Italian patients

In the past, several textbooks defined psoriasis as a non-pruritic dermatosis, but the most recent data in the literature emphasizes the high frequency of pruritus in psoriasis and its impact on the quality of life of patients with psoriasis.Aim of this study was to explore the sensory and affective dimensions of pruritus as well as to assess the impact of itch on quality of life and to evaluate the influence of lifestyles, habits, and various anti-pruritic therapies on pruritus in a large group of psoriatic subjects. The structured Yosipovitch itch questionnaire was given to 240 psoriatic patients. 230 patients returned a complete and detailed questionnaire. Pruritus was referred to by 80% of the patients. Psoriasis area and severity index (PASI) was significantly higher in itching-patients (P=0.04). In half of the patients, itching appeared daily, particularly in the evening. Significant aggravating factors of pruritus were stress, skin dryness, hot water, sweating, elevated ambient temperature, exercise, abundant meals, bad moods, lying position, and contact with clothes. Cold water is the only factor that showed to significantly relieve the pruritus. Anti-pruritic therapies had limited effect.Pruritus is a common, bothersome, and poorly responsive symptom in patients with psoriasis.</p

A Retrospective Epidemiological Study on the Association of Bullous Pemphigoid and Neurological Diseases

Bullous pemphigoid is a rare chronic recurrent dermatosis that is often reported in association with various neurological diseases. No investigation involving a large number of patients has ever been carried out to demonstrate such an association. This study was accomplished by analysing the discharge diagnosis of all hospitalized patients, both day-patients and inpatients, during a 5-year period (1995–2000) covering a total population group of 934,023 living in a region of Italy that has approximately 1,200,000 inhabitants. The results support the hypothesis of an association between bullous pemphigoid, multiple sclerosis and Parkinson's disease on a highly significant statistical basis. The aetiopathogenic mechanisms and the causes that induce the loss of immunological tolerance are not yet understood