Treatment of erosive pustular dermatosis of the scalp: our experience and review of unconventional topical drugs.

BACKGROUND: Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory disorder of elderly individuals, characterized by relapsing pustular and eroded lesions of the scalp, which may lead to scarring alopecia. Treatment is challenging and classically based on topical and/or oral corticosteroids. CASE REPORT: From 2008 to 2022, we treated fifteen cases of EPDS. We used mainly topical and systemic steroids with good results. Nevertheless, several non-steroidal topical drugs have been described in literature for the treatment of EPDS. We have carried out a brief review of these treatments. CONCLUSIONS: Topical calcineurin inhibitors represent a valuable alternative to steroids to avoid skin atrophy. Emerging evidence about other topical treatments, such as calcipotriol, dapsone, zinc oxide, together with photodynamic therapy, are evaluated in our review.

[Should you operate on a uterine septum ?] / Faut-il opérer un septum utérin ?

Uterine septum is the most common congenital uterine malformation and may cause obstetric problems such as repeated miscarriages, premature deliveries or dystocial presentations. It also appears to be associated with infertility. The uterine septum can be demonstrated by ultrasound, MRI and hysteroscopy. The benefit of hysteroscopic septoplasty remains controversial although most studies agree on the benefits of this treatment. It improves the fertility and obstetrical future of women by increasing the rate of pregnancies and live births and reducing the rate of miscarriages. Resection of the uterine septum is therefore encouraged in symptomatic patients but also in prophylaxis, in asymptomatic patients in order to increase the chances of carrying their pregnancy to term.

Le septum utérin est la malformation utérine congénitale la plus fréquente et peut être à l'origine de problèmes obstétricaux tels que des fausses couches à répétition, des accouchements prématurés ou des présentations dystociques. Par ailleurs, il semble également associé à une infertilité. Le septum utérin peut être mis en évidence à l'aide de l'échographie, de l'IRM et de l'hystéroscopie. Le bénéfice d'une septoplastie hystéroscopique reste controversé bien que la plupart des études s'accordent sur les bienfaits de ce traitement. En effet, il permet d'améliorer la fertilité et l'avenir obstétrical des patientes en augmentant le taux de grossesses et de naissances d'enfants vivants et en réduisant le taux de fausses couches. La résection du septum utérin est donc encouragée chez les patientes symptomatiques, mais également, en prophylaxie, chez des patientes asymptomatiques afin d'augmenter les chances de mener leur grossesse à terme.

Ulcerative necrobiosis lipoidica: case report of an atypical presentation and literature review.

Necrobiosis lipoidica (NL) is a rare chronic granulomatous degenerative skin disease by unknown causes, which is mostly associated with diabetes mellitus, usually presenting with typical plaques of the shins. Although less common, some ulcerative forms may be seen in clinical practice. The occurrence of an atypical presentation in one of our patients was the occasion to review the pertinent literature.

Nonfatal road traffic injuries: can road safety campaigns prevent hazardous behavior? An Italian experience.

OBJECTIVES: Road traffic injuries are a widespread problem and are very difficult to prevent. The purpose of this study was to verify whether intensive versus basic road safety education programs are associated with different incidence and severity of nonfatal road injuries. METHOD: The study had an ecological design and involved Local Health Authority One (LHA1) in Salerno, Italy, which includes 20 municipalities. Data on nonfatal road injuries occurring in the periods June to August 2003 and June to August 2008 were obtained from trained operators through the information system of the emergency department. All 20 municipalities received a basic community road safety education program (publicity campaign using bill-posting, brochures, mass media communication with press conferences, articles in local papers, radio and television interviews, and a dedicated LHA1 web site), and 12 municipalities also received an intensive education campaign (in secondary schools, community conferences, and activities organized by police and firefighters). The incidence and severity of nonfatal road traffic injuries were compared between June to August 2003 (before the campaign) and June to August 2008. RESULTS: The total number of injuries in all 20 municipalities in 2003 and 2008 was 907 and 755, respectively. The incidence of injuries decreased in the study period both in the 8 municipalities where only the basic campaign was run (difference in incidence = -0.4; P = .053) and in the 12 municipalities where the intensive campaign was implemented (difference in incidence = -0.5; P < .001); focusing on severity, the incidence of severe injuries decreased or remained the same in the study period in the 2 studied group. DISCUSSION: The results are coherent with other European studies and show that an overall downward trend exists but is presumably not a direct consequence of road safety education. This does not mean that such campaigns are useless (they are important to raise awareness) but that they should be supplemented with complementary activities in order to be really effective.