Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults.

BACKGROUND: Genetic and environmental components may contribute to acne causation. OBJECTIVE: We sought to assess the impact of family history, personal habits, dietary factors, and menstrual history on a new diagnosis of moderate to severe acne. METHODS: We conducted a case-control study in dermatologic outpatient clinics in Italy. Cases (205) were consecutive those receiving a new diagnosis of moderate to severe acne. Control subjects (358) were people with no or mild acne, coming for a dermatologic consultation other than for acne. RESULTS: Moderate to severe acne was strongly associated with a family history of acne in first-degree relatives (odds ratio 3.41, 95% confidence interval 2.31-5.05). The risk was reduced in people with lower body mass index with a more pronounced effect in male compared with female individuals. No association with smoking emerged. The risk increased with increased milk consumption (odds ratio 1.78, 95% confidence interval 1.22-2.59) in those consuming more than 3 portions per week. The association was more marked for skim than for whole milk. Consumption of fish was associated with a protective effect (odds ratio 0.68, 95% confidence interval 0.47-0.99). No association emerged between menstrual variables and acne risk. LIMITATIONS: Some degree of overmatching may arise from choosing dermatologic control subjects and from inclusion of mild acne in the control group. CONCLUSIONS: Family history, body mass index, and diet may influence the risk of moderate to severe acne. The influence of environmental and dietetic factors in acne should be further explored.

Lichen planus pigmentosus-like ashy dermatosis.

Ashy dermatosis, also known as erythema dyschromicum perstans, is an idiopathic dermal melanosis of unknown etiology. We here describe an unusual case of 63-year-old Caucasian male with ashy dermatosis and skin lesion of lichen pigmentosus-like. No treatment was tried because the lesions were totally asymptomatic. After a control, three months later, all lesions had cleared up. This case is of interest because it proves the existence of ashy dermatosis with clinical aspect lichen planus pigmentosus-like. This is the first case in the literature of lichen planus pigmentosus-like ashy dermatosis confirming the view that ashy dermatosis is a variant of lichen planus without the typically band-like infiltrate and Max Joseph spaces.

Bowenoid papulosis at the site of prior herpes progenitalis.

A 35-year-old dentist came to the authors' attention for papular and vegetating lesions that had appeared on his penile shaft over the last 2 months. The lesions differed in their features: pink and vegetating on the left side, brown and papular on the right side (Figure 1). The obvious clinical diagnoses of genital warts on the left and Bowenoid papulosis on the right were confirmed by punch biopsies, which showed epithelial hyperplasia with diffuse cell vacuolization (koilocytes)in the left biopsy and moderate nuclear dysplasia in the right one (Figure 2). Human papillomavirus phenotyping was not performed. Interestingly, the patient reported a clear medical history of herpes progenital is (only one episode) that had involved the right side of his glans and prepuce 4 years ago. An immunomodulating treatment with imiquimod was started in the attempt to cure both the genital warts and Bowenoid papulosis lesions (imiquimod was applied three times a week for 8 weeks). At the end of the treatment, the genital warts had disappeared, whereas many Bowenoid papulosis lesions were still present on the right side of the penis (Figure 3). Treated with liquid nitrogen as well, the Bowenoid papulosis lesions disappeared.