Two cases of Hidradenitis suppurativa and botulinum toxin type a therapy: A novel approach for a pathology that is still difficult to manage.

Hidradenitis suppurativa is a chronic skin disease with an intense inflammatory activation. It typically affects the intertriginous areas with cysts, fistulae, and scarring extremely painful. Patients suffer from severe psychological impact. HS still results in a high unmet medical need with several underdiagnosed cases, probably due to the incomplete knowledge of the pathogenesis of HS. The use of botulinum toxin a has recently been proposed as an effective therapy for HS.

Salivary interleukin-1ß: Oral inflammatory biomarker in patients with psoriasis.

OBJECTIVE: To evaluate salivary interleukin (IL)-1ß levels in patients with psoriasis, before and after treatment with tumour necrosis factor (TNF)-α inhibitors. METHODS: In this pilot study, salivary secretions were collected from patients with psoriasis and untreated healthy control subjects at baseline, and from patients after 12 weeks' treatment with TNF-α inhibitors. IL-1ß levels were determined in saliva samples via enzyme-linked immunosorbent assays, undertaken before and after TNF-α inhibitor treatment. Psoriasis-specific analysis of disease severity and activity were also undertaken. RESULTS: At baseline, patients (n = 25) had significantly higher salivary IL1ß levels than controls (n = 20). In patients with psoriasis, TNF-α inhibitor treatment resulted in significantly reduced IL1ß levels compared with baseline, but IL1ß levels remained significantly higher than in control subjects even after treatment. There was a positive correlation between IL-1ß levels, psoriasis activity and disease index score after TNF-α inhibitor treatment. CONCLUSION: Saliva is a valid noninvasive tool for monitoring inflammation in psoriasis. TNF-α inhibitor treatments appear to interfere with the oral inflammatory process in patients with psoriasis.

Efficacy, safety and tolerability of field treatment of actinic keratosis with ingenol mebutate 0.015 % gel: a single center case series.

INTRODUCTION: Actinic keratosis (AK) is a cutaneous intraepithelial neoplasm appearing within areas referred as 'fields of cancerization'. AK can progress to invasive squamous cell carcinoma. Treatments that target both clinically visible and subclinical AKs in cancerization fields are able to reduce the risk of malignant progression. Ingenol mebutate gel is a new effective topical therapy for AK, used once daily for 2 or 3 days depending on the location of lesions. CASE DESCRIPTION: Three elderly patients with multiple non-hypertrophic AKs within a contiguous 25-cm(2) treatment area on the face or scalp were treated with ingenol mebutate 0.015 % gel once daily for three consecutive days and followed up over a period of 57 days. DISCUSSION AND EVALUATION: Although individual local responses to treatment varied, all patients had total clearance of AK lesions without any sign of recurrence. In addition, all patients said that they were satisfied with the effectiveness of ingenol mebutate treatment and the aesthetic outcome, and would be prepared to use this agent again to treat AK in the future, if necessary. CONCLUSIONS: These three cases demonstrate that ingenol mebutate 0.015 % gel is effective and well tolerated in a clinical setting, with effective clearance of AK lesions present on the face and scalp, and good patient acceptability.