Eccrine Angiomatous Hamartoma with Atypical Localization Treated by Mohs Micrographic Surgery.

ABSTRACT: Eccrine angiomatous hamartoma (EAH) is a rare hamartoma characterized by a benign proliferation of eccrine glands and vascular structures in the dermis. These tumors rarely regress spontaneously, so surgical excision of the involved tissue is required when pain or enlargement occurs. Here, the authors report the clinical case of a patient affected by an extremely painful EAH with the atypical localization at the last phalanx of the thumb of the right hand with involvement of nail matrix and nail bed. This report aims to emphasize the application of Mohs micrographic surgery for the treatment of painful EAH in a very difficult area at potential risk of amputation while preserving the maximum anatomical integrity and function of the damaged area. These results can pave the way for the use of Mohs micrographic surgery for very carefully selected benign neoplasms when their surgical removal is required.

Mental Health Consequences of the COVID-19 Pandemic Long-Term Exposure in Italian Dermatologists.

The present study aimed at assessing the consequences of prolonged exposure to COVID-19 distress on mental health in non-frontline health care workers. For this purpose, we have conducted a survey on 425 Italian dermatologists, in the period February-March 2021. The psychopathological symptoms, depression, anxiety, post-traumatic stress symptoms (PTSD), as well as resilience, have been evaluated. The main factors that influence the physician's psychological health have been also investigated. Our study showed that the physicians older than 40 years, as well as those who lived this period in company, reported more personal resources, better managing the distress. Resilience, COVID-19 beliefs, COVID-19 working difficulties, and age were the common predictors of the severe psychopathological symptoms. An interesting result is that the lower level of resilience was the most powerful predictor of a more severe depression, as well as of a higher severity of generalized anxiety disorder, but not of COVID-19 PTSD. The fear of COVID-19 was the most powerful predictor of COVID-19 PTSD. Home conditions and previous SARS-CoV2 infection constituted significant predictors of severe depressive symptoms, but not of anxiety and COVID-19 PTSD. These results are useful in a better understanding of protective and risk factors involved in COVID-19 long-term distress exposure.

The Use of Allograft Skin for the Treatment of Darier Disease.

Darier disease is an autosomal dominant skin disorder characterized by keratotic papules. After their appearance, these lesions tend to grow over time, producing large and exudative plaques that compromise the general condition of the affected patient's skin. The authors report the clinical case of a patient affected by Darier disease with superinfected de-epithelialized areas over 30% of his body. In addition to antibiotic and antifungal therapy, providers used allograft skin to cover the injured areas and stimulate their progressive re-epithelialization with complete healing after 2 months. To the authors' knowledge, this is the first clinical case of treating Darier disease with allograft skin on an extensively damaged area. The effectiveness of this treatment may lead clinicians to consider allograft skin tissue a new, alternative dressing to treat Darier disease when this pathologic condition manifests with extensive eroded skin.

Platelet-rich plasma on female androgenetic alopecia: Tested on 10 patients.

BACKGROUND: Recently, platelet-rich plasma (PRP) injection has been proposed as a potential adjuvant therapy to treat androgenetic alopecia. AIMS: Investigate the efficacy, tolerability, and clinical improvement of PRP for the treatment of female AGA. PATIENTS/METHODS: A total of 10 female patients affected by AGA and not responding to treatment with minoxidil and/or oral antiandrogens were enrolled. The clinical improvement was evaluated by pull test, global photographs, and Trichoscan at weeks 9, 12, and 24, and hair measurements were performed at baseline and 12 and 24 weeks after the first session. RESULTS: After 24 weeks, the median relative percentage change (%RC) for all the parameters of hair density was mostly positive. After 12 weeks, the medium hair diameter in frontal area showed a significant increase (%RD = 12.5, with P-value < .05), and after 24 weeks (%RD = 14.6, P-value < .05), the vellus relative change instead showed a decrease, especially in the front and the central area, while for the vertex, the decrease was mainly visible at the end (-6.6%). No adverse events were reported. CONCLUSION: Platelet-rich plasma injections have a positive therapeutic effect on hair density and hair diameter improvement.

Outpatient pediatric dermatologic surgery: experience in 296 patients.

From January 2010 to December 2012, 296 skin biopsies were performed in pediatric patients using only local anesthesia (cream and infiltration). The biopsies were divided into three groups: biopsies of skin neoplasms, biopsies of skin rashes and biopsies of follicular-centered lesions. Our data demonstrate the possibility of using this procedure, with the dual advantage of eliminating hospitalization and cost savings.

Familial anetoderma: a report of two families.

Anetoderma is a rare cutaneous disorder where a localized dermal defect of elastic fibers determines depressed areas and often herniated saclike skin. Primary anetoderma is an idiopathic phenomenon while secondary anetoderma is related to various conditions. The term primary anetoderma implies that the lesions occur in clinically normal skin although they may be associated with another dermatological or systemic disease or condition, without a well established relationship. The term secondary anetoderma implies that anetoderma occurred on the same site as another skin lesion. Familial anetoderma is a very rare condition that can be associated with bony, neurological and ocular anomalies. Recently some families with familial anetoderma have been described, where the disease seems to be limited to the skin. The pathogenesis for familial anetoderma is still unclear. It has been reported in only 10 families and in the first 4 reported families, anetoderma was always associated with extra-cutaneous abnormalities, while in the remaining 6 families, all described in last three decades, anetoderma was limited to the skin. We report here another two families with anetoderma without any associated disease and we review the literature on familial anetoderma.

Plaque stage mycosis fungoides treated with bexarotene at low dosage and UVB-NB.

Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL), a non-Hodgkin lymphoma characterized by proliferation of atypical epidermotrophic helper/memory T cells in the skin. Therapeutic management includes topical therapy such as topical corticosteroids, topical chemotherapy or phototherapy; or systemic therapy such as photochemotherapy (psoralen and ultraviolet A [PUVA]), extracorporeal phototherapy, radiation, and mono or polychemotherapy. Herein we report one case of MF unresponsive to conventional therapy, subsequently treated with bexarotene and narrow-band ultraviolet B (UVB-NB). Bexarotene belongs to a new subclass of retinoids, binding primarily the nuclear hormone receptors RXRs. Bexarotene has the same effect as its natural counterpart: 9-cis-retinoic acid. Bexarotene may be used alone or in association with interferon alfa, interferon gamma, extracorporeal photophoresis and PUVA. We utilized 75 mg/day of bexarotene associated with 0.3 J/cm(2) UVB-NB as an initial dose. The sessions were three times weekly and the irradiation was increased by 30% at each session to reach a maximum of 1.6 J/cm(2). After 8 week treatment, clinical lesions markedly improved without recording hypercholesterolemia or hypothyroidism. During the follow-up no relapses were detected. We suggest that the combined therapy UVB-NB and bexarotene may be considered as an alternative treatment to PUVA and bexarotene.