Topical prebiotics/postbiotics and PRURISCORE validation in atopic dermatitis. International study of 396 patients.

Aim: To investigate the efficacy and tolerability of a cream (Rilastil Xerolact PB) containing a mixture of prebiotics and postbiotics, and to validate the PRURISCORE itch scale in the management of atopic dermatitis.Methods: The study is based on 396 subjects of both sexes in three age groups (i.e., infants, children, adults) suffering from mild/moderate Atopic Dermatitis, recruited from 8 European countries and followed for 3 months.Results: The product demonstrated good efficacy combined with good/very good tolerability in all age groups. In particular, SCORAD, PRURISCORE and IGA scores decreased significantly over the course of the study. The PRURISCORE was preferred to VAS by the vast majority of patients.Conclusion: Even though the role of prebiotics and postbiotics was not formally demonstrated since these substances were part of a complex formulation, it can be reasonably stated that prebiotics and postbiotics have safety and standardization features that probiotics do not have. In addition they are authorized by regulatory authorities, whereas topical probiotics are not.

Cutaneous adverse effects of biological therapies for psoriasis.

Psoriasis is a common immune-mediated disease that affects approximately 2% of the world's population. Most patients require lifelong treatment and many of the current systemic therapies are complicated by significant toxicities or inconvenience when administered long-term. New biological psoriasis therapies have been developed, which are thought to act through targeted molecular pathways, so as to administer them continuously without causing any relevant toxicity. Nevertheless, acute and chronic dermatological adverse effects are frequently observed, but knowledge about them is limited and the potential pathogenic mechanisms have not yet been identified. We present 7 patients from our dermatological department who presented different cutaneous adverse effects (2 erythrodermias, 1 palmoplantar pustulosis, 1 flexural psoriasis, 1 eczema, 1 neutrophilic dermatosis and 1 papular eruption) during treatment with biological drugs (4 patients with efaluzimab, 2 patients with infliximab and 1 patient with etanercept). The use of biological agents is expanding worldwide as new alternative treatments for psoriasis and other chronic inflammatory diseases. The increased use of these treatments has allowed identification of their acute and chronic systemic adverse events. Nevertheless, the dermatological adverse events of these biological drugs are less well known due to few reports about them and lack of information about their pathogenic mechanisms. Exact diagnosis of these cutaneous eruptions is very important in order to decide the need for discontinuation of the biological treatment.

Abortive or minimal-growth hemangiomas: Immunohistochemical evidence that they represent true infantile hemangiomas.

BACKGROUND: Infantile hemangiomas have a characteristic natural history of rapid proliferation in the first weeks of life followed by spontaneous involution. At birth, they may be present as a precursor lesion. Sometimes one may see precursor lesions that never undergo a growth phase or that undergo minimal growth. It is unclear the exact nature of these precursor-like lesions. OBJECTIVE: We sought to describe the morphology and histopathology of these precursor-like lesions. METHODS: We describe 4 patients with macules resembling precursor lesions of hemangiomas that did not show proliferation phase or minimal growth. The histopathologic and immunohistochemical study with glucose transporter-1 was performed in all of these cases. RESULTS: The skin biopsy specimen showed superficial ectatic vessels that reacted with anti-glucose transporter-1 antibodies. All skin biopsy specimens exhibited capillary lobules in papillary dermis and, in two of them, in the reticular dermis and subcutis. LIMITATIONS: This text is limited by the number of cases reported. CONCLUSIONS: Precursor lesions of hemangioma that do not show proliferation phase or minimal growth represent, in the view of glucose transporter-1 immunoreactivity, true hemangiomas of infancy with an aborted or arrested growth cycle.