Psoriasis and oral lesions: multicentric study of Oral Mucosa Diseases Italian Group (GIPMO).

OBJECTIVE: This is a multicentric, observational and controlled study designed to verify the existence of a significant association between plaque-type psoriasis and oral lesions, such as geographic tongue and/or fissured tongue. STUDY DESIGN: during a period of 9 months all consecutive patients with plaque-type psoriasis were enrolled using simple nonrandom (sequential) sampling. The control group included healthy subjects presenting to the same Dermatology centers to monitor pigmented skin lesions; the patients were matched for age and sex. All patients were examined for oral lesions. RESULTS: Out of a total of 535 psoriatic patients and 436 control group patients, oral mucosal lesions were detected in 188 (35.1%) and 86 (19.7%) cases, respectively, and the difference is statistically significant. Fissured tongue (FT) and geographic tongue (GT), which were most frequently detected, were seen more frequently in psoriatic patients (FT: 22.6%; GT: 9.1%) than the control group (FT: 10.3%; GT: 5.2%) (p<0.05). CONCLUSIONS: On the basis of the similar studies reported in the literature and the large number of patients involved in our study, we can conclude that FT and GT can be clearly suggested as oral manifestations of plaque-type psoriasis, although the reason for this association is not clear.

Chrysaora hysoscella in the Gulf of Trieste: presence, evolution and cutaneous toxicity in man.

In the past few years important changes in the occurrence of scyphomedusae have been observed in the North Adriatic Sea and in particular in the Gulf of Trieste, often reaching alarming proportions. Spring coastal blooms of C. hysoscella were observed in 1989. Until 1989, this jellyfish was considered to be innocuous but the data presented show its cutaneous toxicity in man.

Evaluation of the serum T cell population variations induced by PUVA therapy.

In the present study we evaluated the effects of UVA irradiation on the serum T cell subpopulations (CD3, CD4, CD8, CD4/CD8, NK, T lymphocytes/mm3) by means of a Fluorescence Activate Cell Sorter (F.A.C.S. 420, Becton Dikinson). Twenty-eight psoriatic patients, never previously treated with PUVA, received UVA radiations (cabin Waldman 8001 K). Blood samples were taken before therapy and after 60 J/cm2 and 120 J/cm2 irradiations. Results were compared with those of our healthy control group of volunteers. A decrease of CD4 positive cells was observed in the psoriatic group before therapy. PUVA did not induce any statistically significant modification of the populations studied, except for a progressively increasing trend of CD4 positive cells. These data seem to stress that a medium-term PUVA therapy does not significantly modify the serum level of the T cell populations.

The nails in psoriatic arthritis.

Nail involvement is often present in patients suffering from psoriatic arthritis. Up to the present, no data concerning the rate of onychopathy associated with psoriatic arthropathy have been reported. 52 patients with psoriatic arthropathy have been studied with particular attention to the possible presence of and the typical features of onychopathy. Nail changes were noted in 86.5% of patients affected by arthropathic psoriasis. The commonest toenail alteration was subungual hyperkeratosis, while the most frequent fingernail change was pitting.

Scanning electron microscopy study of hair shaft disorders in psoriasis.

Studies on scalp hair from psoriatic lesions have revealed marked irregularities in the cuticular pattern. The aim of this study was to investigate the incidence of hair shaft disorders in psoriatic patients and to evaluate the possibility of a correlation with scalp involvement. We examined hair from 39 psoriatic patients using scanning electron microscopy and compared it with hair from a control group of 12 healthy people. We confined our observations of the hair fibres to the areas nearest the root. Our data confirm previous observations indicating that dystrophic changes in hair cuticle cells occur more often in hairs from both unaffected and affected skin of psoriatic patients compared with normal subjects. No differences were observed between hair shafts taken from affected and unaffected psoriatic areas; cuticular breakage and an abraded cuticular surface were present only in the hair of psoriatic patients.

Psoriasis and endothelins.

BACKGROUND: Psoriasis is characterized by an abnormal proliferation and increased turnover of keratinocytes, the presence of acute and chronic inflammatory cells and microangiopathic changes. Endothelins are a family of peptides which have been investigated especially for their effects on the cardiovascular system. Recent studies have demonstrated their involvement also in human skin. AIM OF THE STUDY: We evaluated the Endothelin-1 and 2 plasma levels in psoriatic patients, as endothelin-1 can be produced in vitro by keratinocytes and can stimulate the proliferation of fibroblasts as well as modify the skin microcirculation dynamics. PATIENTS AND METHODS: We studied 30 patients: 10 affected with psoriasis (PASI from 5 to 10), 10 affected with cardiovascular diseases and 10 healthy controls. The Endothelin-1 and 2 plasma levels were evaluated by radio-immunoassay procedure. RESULTS: A significant increase in Endothelin-1 and 2 plasma levels was observed in the psoriatic patients, in comparison with the controls. CONCLUSIONS: Our data seem to suggest a possible relationship between psoriasis and increased plasma level of endothelin-1 and 2, though the possible role played in the pathogenesis of psoriasis needs further studies.

Impetigo herpetiformis and RhE isoimmunization: a case report.

Impetigo herpetiformis is a rare acute eruption associated with severe systemic disturbances, typically occurring in pregnant women. We describe the case of a 33-year-old woman who presented with impetigo herpetiformis during her third pregnancy, the appearance of which coincided with an increase in the titer of E antigen antibodies.

Treatment of a pigmented lesion induced by a Pelagia noctiluca sting.

A young man had persistent hyperpigmentation on the face following a jellyfish (Pelagia noctiluca) sting four years previously. This localized lesion resolved within forty days after topical hydroquinone (1.8 percent) therapy was instituted. This case is presented to demonstrate that persistent hyperpigmentation occurring after coelenterate stings can be treated with a topical bleaching agent.

Dermatitis due to Olindias sambaquiensis: a case report.

Olindias sambaquiensis, Muller 1861 (Hydrozoa: Limnomedusae: Olindiidae) is a neritic jellyfish endemic in the Blanca Bay area (South of Buenos Aires, Argentina). In this paper we describe the first report of a dermatitis caused by this jellyfish in a thirty-four-year-old marine biologist who presented with an erythematous vesicular eruption after contact with Olindias sambaquiensis. Some preliminary ultramicroscopic observations on the nematocysts of this jellyfish are also reported.

Psoriatic arthritis treated with cyclosporin A.

Cyclosporin A (CyA) is a very effective immunosuppressor for inhibition of the humoral immune response and especially for cell mediation and was originally indicated for transplantation of organs and autoimmune diseases. More recently, CyA has been used successfully for severe psoriasis. In this study, the authors describe the results obtained from 8 patients who presented with a psoriatic arthropathy, treated with small doses of CyA (3-5 mg/kg/day). There were reactions in five of them, in two patients the Ritchie index decreased moderately and in one patient the arthritic psoriasis was significantly improved.

Allergic contact dermatitis in Trieste from 1987 to 1991.

Between 1987 and 1991, the authors made patch-tests on 1,427 patients, 389 male and 1,038 female, of mean age 36 years (6-70 years) and mostly suffering from eczema. The standard tests of Italian Group for Research into Contact Dermatitis and the Environment (GIRDCA) were used, following the best data of recent years. Nickel sulphate, thiomersal, "Fragrance mix", cobalt sulphate and potassium bichromate were the allergens varied with age: nickel and thiomersal were most frequently positive between 20 and 30 years. In contrast, the highest frequency of positivity to fragrance mix was seen between 40 and 60 years. Positivity to a simple allergen had a tendancy to reduce with age.

[Dermatotoxicity of the Adriatic jellyfish]. / Dermotossicità da meduse del mare Adriatico.

We have tested the dermatotoxicity of some purified nematocysts preparations of Aurelia aurita, Chrysaora hysoscella, Rhizostoma pulmo, in 25 volunteers by means of scratch-patch test. Our results show the validity of the method used for nematocyst purification. The few skin reactions obtained confirm the low dermototoxicity of the jellyfish studied.

[Nickel and chromium. Analysis of 3 detergents using atomic absorption spectrophotometry]. / Nichel e cromo. Analisi allo spettrofotometro ad assorbimento atomico di tre detergenti.

It is well known that Nickel and Chromium are present, at different concentrations, in detergents used for washing-up, hand-washing and cleaning surfaces. In the present study we have analysed three trade marks of detergents (one for each different use) to evaluate, by means of atomic absorption spectroscopy, whether the concentrations previously detected are specific to a particular trade mark or are connected with the metals concentration variability typical of all detergents as commercial products. According to our results, Nickel and Chromium are always present, at different concentrations, in all the samples tested; detergents used for hand-washing contain the highest Nickel percentage; the concentrations observed show discrete variations also within the same trade mark.

[Dermatotoxicity caused by Chrysaora hysoscella. Presentation of a case]. / Dermotossicità da Chrysaora hysoscella. Presentazione di un caso.

Chrysaora hysoscella L. rarely occurs in coastal waters of the Adriatic sea and is usually considered an innocuous jellyfish. In June 1989, P.D.N., a 29 year old healthy female, biologist at the Marine Biology Laboratory of Trieste, treated some samples of Chrysaora hysoscella captured that day. She took the animals from the transport tanks and cut the tentacles and oral arms from their bell. About ten minutes later she felt itching and burning of her hands, especially the right one. Twenty minutes later erythematous and slightly edematous lesions appeared on her fingers. These lesions spontaneously disappeared in about 2 hours. We decided to test Chrysaora hysoscella dermotoxicity on healthy volunteers by cutting a Chrysaora hysoscella tentacle and placing it on a gauze soaked in a solution of 3% NaCl and applying then to the volar side of the right wrist for one minute. Both volunteers presented itching and burning within forty seconds of contact. Three minutes later erythematous and vesicular lesions appeared on the sting site. To the best of our knowledge this is the second reported but first documented report of the dermotoxic effect of Chrysaora hysoscella. We underline that the absence of other previous reports may be due to both the relative rarity of this jellyfish and to the fact that people often confuses Chrysaora hysoscella with other more common jellyfish.

Optimization of systemic treatments for chronic plaque psoriasis. Recommendations for switching and transitioning.

AIM: The aim of this study was to provide practical recommendations for optimizing the use of conventional and biological systemic treatments for moderate-severe chronic plaque psoriasis, particularly in case of transitioning and switching. METHODS: A total number of 147 dermatologists from 33 different countries including Italy achieved consensus in providing practical recommendations for the use of conventional and biological treatments for moderate to severe psoriasis based on systematic literature review and/or expert opinion. RESULTS: In general, the continuous treatment regimen should be preferred in order to achieve a complete and long-term control of psoriasis. However, the treatment could be stopped or the dose reduced in case of complete disease clearance. A conventional drug could be associated to biological treatment in selected cases. Transitioning and/or switching could be considered in case of inefficacy or intolerance. A period of wash up is required if transitioning or switching is due to safety issues. CONCLUSION: This study provides practical suggestions for the optimal use of conventional and biological treatments for chronic plaque psoriasis.