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1.
J Wound Care ; 31(6): 492-500, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35678785

RESUMO

OBJECTIVE: To evaluate the clinical efficacy of a hypericum and neem oil dressing, Primary Wound Dressing [ONE] (1PWD) (Kerecis AG, Switzerland), in a patient population with dehiscence of surgical wounds with critical colonisation/infection. Efficacy was defined as resolution of inflammatory/infective symptoms. METHOD: A randomised, controlled, single-blinded, parallel-arms phase III study was conducted comparing the experimental medication to silver-based dressings. All patients were evaluated at enrolment, on days 7, 14, 21 and 28. Improvement of inflammatory/infective symptoms was measured by detecting seven items of the Bates-Jensen Wound Assessment Tool (BWAT). Pain was assessed using the Numeric Rating Scale (NRS). RESULTS: The study enrolled 99 patients. Follow-up was completed in 49 patients in the experimental group and 48 patients in the control group. Overall BWAT evaluation demonstrated similar outcomes between the groups: t=0.23, p-value=0.81, 95% confidence interval (CI): -13.3-10.8. Furthermore, when evaluating the seven items of the BWAT relating to inflammatory signs, there was not a significant difference between the groups: t=0.38, p=0.35, 95% CI: -2.8-2.7. However, when an analysis using the NRS pain scale was performed, a statistically significant pain reduction was demonstrated in favour of the experimental group: t=7.8, p<0.0001, 95% CI: 2.918-4.8819. CONCLUSION: This randomised controlled trial confirmed the efficacy of 1PWD, an investigational product, in the management of surgical dehiscence with critical colonisation or infection, with the added benefit of significant pain reduction when compared with a silver-based dressing.


Assuntos
Hypericum , Ferida Cirúrgica , Glicerídeos , Humanos , Dor , Prata/uso terapêutico , Ferida Cirúrgica/terapia , Infecção da Ferida Cirúrgica/epidemiologia , Terpenos , Cicatrização
2.
J Paediatr Child Health ; 59(11): 1271, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36465007

Assuntos
Vesícula , Polegar , Humanos
8.
Ital J Dermatol Venerol ; 159(2): 166-173, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38650496

RESUMO

BACKGROUND: Psoriasis (P) and atopic dermatitis (AD) share some common characteristics. The resulting clinical picture with shared manifestations is a new entity called psoriasis dermatitis (PD), atopic psoriasis or psorema. The purpose of this study was to identify the clinical manifestations of this new dermatological condition, focusing on the adult population. METHODS: We recruited adult patients from two outpatient clinics, the "severe psoriasis" and the "adult atopic dermatitis," between January 1st, 2021, and December 31st, 2021. The 26 patients meeting the inclusion criteria were followed for 12 months, and two control groups of patients were enrolled in the same period. RESULTS: The frequencies of the variables examined within the patients affected by PD were compared with those of P or AD group. The age at disease onset was significantly higher in PD patients and the duration of symptoms was also significantly lower in PD patients, compared to both P and AD groups. Affected areas were similar between PD and P, instead the scalp, feet and genitals were more frequently involved in the PD group than in the AD group. CONCLUSIONS: P and AD seem part of a spectrum rather than a dichotomy, where PD is an entity in the middle of this spectrum.


Assuntos
Dermatite Atópica , Fenótipo , Psoríase , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idade de Início , Estudos de Casos e Controles , Índice de Gravidade de Doença , Idoso , Adulto Jovem
9.
J Dermatolog Treat ; 33(2): 941-945, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32643474

RESUMO

INTRODUCTION: Lichen sclerosus (LS) is a chronic relapsing disease with a predilection for the anogenital areas of patients of both sexes and at all ages. In males, LS is usually a late diagnosis, increasing the odds for serious complications up to the worse clinical scenario. LS is known to affect the quality of patients' social and interpersonal life. Here, we designed a study to monitor the possible beneficial effects of fractional photo-thermolysis with CO2 laser for treating penile LS during a non-active phase of the disease. METHODS: Ten patients were enrolled in this study. They all underwent three ablation laser sessions, followed by a follow-up visit 6 months after the last treatment. In four out of five visits conducted, questionnaires were filled in by both clinician and patients to evaluate outcomes on quality of life (DLQI test), symptoms of LS (MenLas Observer Scale and MenLas Patient Scale), and sexual function (MSHQ questionnaire). RESULTS: Our study shows that treatment with fractioned laser CO2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life. CONCLUSIONS: Our study shows that treatment with fractioned laser CO2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life.


Assuntos
Terapia a Laser , Lasers de Gás , Líquen Escleroso e Atrófico , Dióxido de Carbono , Feminino , Humanos , Lasers de Gás/uso terapêutico , Líquen Escleroso e Atrófico/complicações , Líquen Escleroso e Atrófico/cirurgia , Masculino , Qualidade de Vida
10.
Skin Appendage Disord ; 8(6): 482-485, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36407645

RESUMO

Introduction: Erosive pustular dermatosis of the scalp (EPDS) is an inflammatory scalp condition that usually affects the elderly, while only few cases have been reported in childhood. In children, it may mimic fungal or bacterial infections, especially kerion. Case Presentation: We describe the usefulness of trichoscopy as a supportive diagnostic tool in 2 cases of pediatric EPDS. Discussion: Clinical distinction between EPDS and different types of alopecia in children is difficult, with a significant likelihood of diagnostic errors and delay in therapy. Trichoscopy may provide a noninvasive option that can help avoid invasive diagnostic procedures in children.

11.
Acta Dermatovenerol Croat ; 29(3): 169-170, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34990348

RESUMO

Dear Editor, A 45-year-old man presented with a large, dark, keratotic, warty, and friable plaque on the distal posterior aspect of the left leg (Figure 1, a). The patient reported that the lesion was not present at birth but had appeared approximately at the age of three as an erythematous patch that progressively grew over the time. During adolescence, the surface of the lesion became rough and warty and was easily traumatized due to its location, resulting in recurrent bleeding episodes over a period of years. For this reason, the patient requested lesion removal. The patient did not report any other significant comorbidity, and physical examination revealed no other abnormalities. A shaving biopsy of the lesion was performed, and histopathology highlighted ectatic vascular spaces with some luminal red blood cell beneath a papillomatous and hyperkeratotic epidermis (Figure 1, b). Based on clinical and histopathological features, a diagnosis of angiokeratoma circumscriptum naeviforme (ACN) was established. ACN is one of the five disorders belonging to the group of angiokeratomas (AKs) that also include AK of Mibelli, AK of Fordyce, solitary or multiple AK, and AK corporis diffusum. Among these variants, ACN is the rarest and is seldom studied (1). AKs are benign vascular anomalies of the superficial vascular plexus that appear as dark red papules and plaques arranged either discretely or in clusters. ACN lesions are typically situated unilaterally on the lower limbs, especially on the legs and feet, but can occasionally occur elsewhere. Lesions are generally noted in early childhood. The early lesions are flat and reddish in color, while older lesions become increasingly studded and acquire a verrucous or warty surface. There is no tendency of spontaneous improvement, and minor traumas can easily cause beading and infection (2). While the plaques were linear in disposition in most of the cases reported in the literature, a peculiar feature of our case was the isolated, round, and giant appearance of the plaque. Even though ACN is not typically associated with other abnormalities, coexistence with other vascular malformations has been reported in some cases, including AK of Fordyce, Cobb syndrome, Klippel-Trenaunay syndrome, nevus flammeus, infantile hemangioma, and traumatic arteriovenous fistula (3). From a histological point of view, ACN appears as dilated dermal papillary capillaries drained by dilated venules. The overlying epidermis shows a variable degree of acanthosis, papillomatosis, and compact hyperkeratosis. Typically, the deep dermis and hypodermis are not involved, helping distinguish them from verrucous hemangioma (4). Lichen simplex chronicus, verrucous carcinoma, and verrucous melanoma must also be considered in the differential diagnosis (5). Recurrent bleeding or cosmetic reasons are common indications for treatment. Surgical excision represents the most effective option. Other possibilities include diathermy, electrocautery, cryosurgery, or laser (6). In our case, there was no macroscopic residual disease after the shaving biopsy. A collagen dressing was applied, and the wound underwent second intention healing in three weeks. There was no evidence of local recurrence after 18 months. References: Das A, Mondal AK, Saha A, Chowdhury SN, Gharami RC. Angiokeratoma circumscriptum neviforme: An entity, few and far between. Indian Dermatol Online J. 2014;5:472-4. Mittal R, Aggarwal A, Srivastava G. Angiokeratoma circumscriptum: a case report and review of the literature. Int J Dermatol. 2005;44:1031-4. Wankhade V, Singh R, Sadhwani V, Kodate P, Disawal A. Angiokeratoma circumscriptum naeviforme with soft tissue hypertrophy and deep venous malformation: A variant of Klippel-Trenaunay syndrome? Indian Dermatol Online J. 2014;5(Suppl 2):S109-S112. Oppermann K, Boff AL, Bonamigo RR. Verrucous hemangioma and histopathological differential diagnosis with angiokeratoma circumscriptum neviforme. An Bras Dermatol. 2018;93:712-5. Goldman L, Gibson SH, Richfield DF. Thrombotic angiokeratoma circumscriptum simulating melanoma. Arch Dermatol. 1981;117:138-9. del Pozo J, Fonseca E. Angiokeratoma circumscriptum naeviforme: successful treatment with carbon-dioxide laser vaporization. Dermatol Surg. 2005;31:232-6.


Assuntos
Angioceratoma , Hemangioma , Papiloma , Neoplasias Cutâneas , Angioceratoma/diagnóstico , Pré-Escolar , Humanos , Perna (Membro) , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico
12.
Clin Case Rep ; 9(4): 2477-2478, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33936720

RESUMO

Koebner phenomenon regards the formation of a psoriatic lesion after a trauma, including tattoo, insect bite or other injuries. Although this manifestation is not specific for psoriasis, physicians should be aware because early recognition may be helpful in making the diagnosis when present.

13.
J Dermatolog Treat ; 32(7): 800-802, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31858840

RESUMO

INTRODUCTION: Extra-mammary Paget's disease is a rare form of intraepithelial adenocarcinoma with a variable pattern of invasion. Vulvar Paget's disease represents 1% of all vulvar cancers. Standard treatment is surgical excision, however, the recurrence rate is high and surgery leads to anatomical, functional and sexual morbidity. Some studies suggest the efficacy of photodynamic therapy following CO2 Laser irradiation as treatment for this disease. METHODS: In the present study, ten patients with vulvar Paget's disease underwent fractional carbon dioxide (CO2) laser abrasion, followed by 3 h of occlusive application of aminolaevulinic acid (ALA) and then 100 J/cm2 irradiation with a 630-nm lamp. This combination treatment regime was repeated every 2 weeks for a total of 5 times. RESULTS: At the end of the 12-month follow-up period, only two patients maintained a complete remission of the disease and recurrence was observed in all patients who had originally shown a partial remission. CONCLUSIONS: According to our experience, Photodynamic Therapy-ALA following fractional CO2 Laser does not seem to be an effective treatment for vulvar EMPD in the long term.


Assuntos
Lasers de Gás , Doença de Paget Extramamária , Fotoquimioterapia , Neoplasias Vulvares , Dióxido de Carbono , Feminino , Humanos , Lasers de Gás/uso terapêutico , Doença de Paget Extramamária/tratamento farmacológico , Neoplasias Vulvares/tratamento farmacológico , Neoplasias Vulvares/radioterapia
14.
Dermatol Pract Concept ; 10(4): e2020122, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33150043

RESUMO

BACKGROUND: Congenital triangular alopecia (CTA) is a benign, asymptomatic, nonprogressive, localized and noncicatricial type of alopecia that is usually first noted during infancy or childhood. The pattern of hair loss is traditionally described as triangular, oval or lancet shaped with apex toward the vertex. OBJECTIVE: We present a case series of CTA located in unusual sites. PATIENTS AND METHODS: We performed trichoscopy in 78 patients with CTA. From this group, we selected 10 individuals (4 males and 6 females) whose disease was not localized on the typical scalp area. RESULTS: The alopecic area was located on the occipital region in 5 patients, the parietal region in 4 patients, at the vertex in 1. With trichoscopy, vellus hairs were detected in all patients, and evidence of empty follicles was noticed only in 3 patients. CONCLUSIONS: In contrast with the preconceived notion that all CTAs are frontotemporal, our case series points out that this disease could be localized in other scalp sites.

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