Photodynamic Therapy with 5-Aminolevulinic Acid Patch for the Treatment of Actinic Keratosis.

Photodynamic therapy (PDT) using 5-aminolevulinic acid (5-ALA) is an emerging treatment option in the care of actinic keratosis (AK). A self-adhesive 5-ALA patch was recently developed that allows a precise PDT procedure. Here, we review the current literature and report the findings of our case series that observed the outcomes and safety of 5-ALA patch PDT. Ten patients with a total of 40 AKs were treated with a single session of conventional or daylight PDT using 5-ALA patch at the Department of Dermatology and Venereology, Sapienza University of Rome or at the European Institute of Oncology, Milan, Italy. Complete response was observed in three patients, while partial response was seen in seven patients. Overall tolerability was good or excellent, with local adverse events observed in four patients. This is the first case series reported where the 5-ALA patch was applied using daylight PDT, and its efficacy and tolerability in the treatment of AK were demonstrated. In conclusion, the self-adhesive 5-ALA patch is a convenient application of PDT that provides a well-tolerated and effective treatment option with satisfactory cosmetic outcomes.

Actinic keratosis: review of the literature and new patents.

Actinic Keratoses (AK) are considered a worldwide problem with continuously increasing incidence. They clinically present as rough or scaly plaques and are histologically characterized by a proliferation of atypical keratinocytes limited to the epidermis. AK are considered as an early step in the continuum of transformation from normal skin to invasive squamous cell carcinoma (SCC). These lesions develop on a background of field cancerization in which chronically UV- damaged-areas accumulate molecular changes, but remain clinically normal for prolonged periods. The presence of certain clinical features of AK, such as large size, ulceration, or bleeding, suggests an increased risk of disease progression. The risk is also increased by evidence of extensive solar damage, advanced age, and immune-suppression. Many treatment modalities are available, although recent developments have focused on the management of the whole actinically damaged field. In this regard, several topical drugs have been approved, differing in efficacy, side effects, application and cost. Research continuingly aims to develop the "ideal" treatment which combines high clearance rates with few side effects, short treatment duration and low costs. Herein, we aim to give an overview on current treatment modalities including their mechanism of action, application scheme and common side effects. Furthermore, recent patents in the field and future aspects are discussed in this review.

Hydrofiber dressing and wound repair: review of the literature and new patents.

Effective management of wound healing is a considerable challenge for clinicians. Patients underlying condition, accurate assessment of the wound and exudates, as well as selection of an appropriate dressing is all important factors for success. A variety of dressings are available to the clinician for the management of exudates. Hydrofiber dressings are a relatively new concept, and can be very cost effective because they can be worn for several days at a time. This report will review clinical evidences on the use of Hydrofiber dressing for the management of epithelial lesions, deal with current knowledge on the mechanism of action of this compound towards the epithelial wound healing process, immunological aspects and will also discuss relevant patents.

Skin grafting: comparative evaluation of two dressing techniques in selected body areas.

BACKGROUND: Skin grafting is a frequent surgical procedure used to reconstruct a soft-tissue deficit. Tie-over bolster dressing is the traditional technique made to fix the graft to the recipient area. This dressing does not always provide satisfactory results in some difficult body areas, with poor skin graft taking as an outcome. Here, we used a soft "polyurethane sponge" as a compressive tool. MATERIALS AND METHODS: A therapeutic protocol was used to select patients, splitting them into 2 groups: tie-over bolster dressing versus polyurethane sponge. Data analysis and calculation of sample size were performed using the Statistical Package for the Social Sciences Windows version 13.0. RESULTS: Of the 106 patients treated by traditional compressive dressing, 11 had complications, thus achieving a success rate of 89.6%. Of the 106 patients treated by polyurethane sponge dressing, 3 had complications, providing a success rate of 97.1%. CONCLUSION: Compared with the conventional tie-over dressing, the sponge dressing technique was demonstrated to be more successful in graft taking in selected areas.

Divided nevus of the eyelids: three case studies.

Divided nevus or kissing nevus is a rare form of congenital nevus that usually occurs on adjacent parts of the upper and lower eyelids of one eye. Most often, the formation is present from birth, but it may also appear later. Three new cases during the period 1996 to 2004 are reported. Two of them were treated in our unit for oncological, functional and aesthetic purposes, and one preferred not to be operated on. All our patients had divided nevus of the left eyelid. In the first case, the reconstruction was achieved with two tarso-conjunctival flaps covered with skin grafts. In the second case, we used a technique based on autologous cultivated conjunctival epithelium. The third patient preferred not to be operated on and is still under clinical follow-up. Because of the severe disfigurement, risk of later malignant change in the lesion, and the possibility of deprivation amblyopia, early surgical treatment is very important.

Correction of hypospadias with a vertical preputial island flap: a 23-year experience.

PURPOSE: We report our experience using the preputial island flap technique (Scuderi procedure) to correct penile hypospadias. MATERIALS AND METHODS: A total of 152 patients underwent repair between 1982 and 2004. Nine patients (6%) had proximal hypospadias, 46 (30%) had mid penile hypospadias and 97 (64%) had distal hypospadias. A total of 146 patients (96%) had not previously undergone surgical treatment, while 6 (4%) had undergone surgery. RESULTS: After the primary repair 3 patients had fistula and 10 had mild stenosis. The immediate success rate was 91.4% (139 of 152 patients), which later increased to 98% (149 of 152) after nonsurgical treatment of the stenoses. CONCLUSIONS: Preputial island flap urethroplasty is a versatile operation that corrects hypospadias and is particularly indicated if there is associated severe penile curvature, with a low complication rate and superior cosmetic results.

Power-assisted lipoplasty versus traditional suction-assisted lipoplasty: comparative evaluation and analysis of output.

Power-Assisted lipoplasty (PAL) is a new method introduced to simplify and standardize surgical results of traditional suction-assisted lipoplasty (SAL). Comparative studies already have demonstrated PAL to be a handy, atraumatic, time- and fatigue-sparing technique. The authors performed a pilot study to compare the output capacity of PAL and SAL in 15 healthy female patients. The general and the specific per area outputs over 1 min from symmetrical areas were assessed. The results confirmed the efficiency of PAL (17.41% increase in average specific area output, as compared to SAL) and the distribution of fat in major "fat storage" areas such as the abdomen and the anterior thigh. Specific per area output indicated a higher suction capacity for PAL in all areas except the inner thigh. The efficiency of PAL seemed to be less influenced than that SAL by fat distribution.