Superficial radiotherapy for multiple keratoacanthomas.

We report the case of a 76-year-old Caucasian woman who attended our clinic with multiple keratoacanthomas. Radiotherapy was considered a viable and effective option in such an old patient, who could not be a good surgical candidate for number and distribution of the lesions, and for the age. After a 12-month follow-up, we observed the complete and global disappearance of the lesions; the patient was therefore very satisfied especially in view of the clinical outcome. According to our point of view, radiotherapy allows the physician to obtain a good oncological radicality and excellent cosmetic results too.

Therapeutic experience with ketoconazole.

The efficacy of ketoconazole was evaluated in forty-five patients with dermatophytoses, in twelve with candidosis, in two with fixed cutaneous sporotrichosis, in one with primary cutaneous cryptococcosis and in one with pulmonary aspergillosis. Patients received 200 mg daily of ketoconazole until complete cure, except for patients with vulvovagnitis who received 400 mg daily for five days. All patients with dermatophytoses were cured within 20 to 40 days. No recurrences were observed at post-therapy follow-up. Patients with candidosis were also cured, with only one recurrence. Patients with deep mycoses recovered, except for one with fixed cutaneous sporotrichosis, who showed slight improvement. No significant side-effects were observed during therapy. In conclusion, ketoconazole is an effective therapeutic agent for fungal infections.

Structural alterations of basal keratinocytes and capillary loop in psoriasis during treatment with topical calcipotriol.

Recent research has demonstrated the activity of calcipotriol, effective as a potent inhibitor of cellular proliferation and known to increase differentiation in a number of cell lines in the topical treatment of psoriasis. Vit D3 receptors are expressed in keratinocytes and vascular endothelial cells. We studied the alterations in basal keratinocytes (stem cells or anchoring cells) and endothelial cell modification in 6 patients with psoriasis treated with calcipotriol ointment twice a day for 4 weeks. The samples were embedded in Epon resin for thin section and ultrathin section examination by electron microscopy. A normal pattern of distribution of the two different types of basal keratinocytes was observed before treatment. After treatment, only anchoring cells were detected. The alterations of endothelial cells in capillary loop disappeared after treatment, presenting normal aspects. Our morphological findings suggest that calcipotriol is therapeutically effective, due principally to an inhibition of cellular proliferation.

A case of vesiculo-bullous Darier's disease associated with bipolar psychiatric disorder.

We describe the case of a 71-year-old men suffering from Darier's disease since his youth and presenting with intensely itching, vesicular and pustular lesions, localized on his arms, legs and on the ulnar side of his right hand. The patient also had a 30 year-history of bipolar psychiatric disorders. The histopathological examination of lesional skin showed suprabasal acantholytic clefting, hyperparakeratosis, and dyskeratosis. Histopathological and immunopathological (direct and indirect immunofluorescence) results, were consistent with vesiculo-bullous Darier's disease. Corticosteroid therapy with methylprednisolone at low dosage (0.2 mg/kg/day) was started with a quick resolution of the vesicular lesions on his arms and legs.

[Defocused CO2 laser in the treatment of leg ulcers. Preliminary results]. / Il laser CO2 defocalizzato nella terapia delle ulcere degli arti inferiori. Risultati preliminari.

We studied the therapeutic action of CO2 Laser on leg ulcers due to chronic venous hypertension in 30 subjects. Our findings show good results in reducing pain and leg oedema and wound healing.

[Pityriasis rosea-like skin eruptions caused by captopril]. / Eruzione cutanea da captopril "pitiriasi rosea-like".

Captopril is an antihypertensive drug that works by inhibiting the angiotensin-converting enzyme and provokes increased levels of plasma quinine. In the case here reported a picture of pityriasis rosea-like reaction is described. The frequency of the observed and reported reactions by captopril suggests a particular caution in the use of this drug.