Comparison of Allevyn Adhesive and Biatain Adhesive in the management of pressure ulcers.

OBJECTIVE: The primary objective was to assess dressing delamination and the ensuing potential consequences during wear and/or removal, as well as the effect of residue remaining in the ulcer following foam breakdown. METHOD: In this prospective multicentre study, 32 patients with a grade II or III pressure ulcer were randomised to receive either Allevyn Adhesive or Biatain Adhesive dressing. The performance of the dressings was assessed over seven dressing changes or a maximum of six weeks. The primary efficacy variable was the proportion of patients with at least one delaminated dressing (delamination being defined as the falling apart of a dressing during wear or removal, or the presence of residue from the dressing in the ulcer). RESULTS: Allevyn Adhesive was significantly less likely to delaminate than Biatain Adhesive: 83% of patients given Biatain Adhesive had a dressing that delaminated compared with 14% for Allevyn Adhesive (p = 0.014). Furthermore, a greater proportion of the Biatain Adhesive dressings delaminated compared with the Allevyn Adhesive dressings: 50% versus 4% (p < 0.001). Allevyn Adhesive performed significantly better in the following parameters: handling exudate (p = 0.044), comfort (p = 0.007), ease of application (p = 0.004), conformability during application (p = 0.003) and removal (p < 0.0001), and adherence to the skin during application (p = 0.003) and prior to removal (p = 0.011). Three patients given Allevyn Adhesive (21%) reported three adverse events; six patients given Biatain Adhesive (33%) reported eight adverse events. CONCLUSION: Allevyn Adhesive is effective and well tolerated in the management of pressure ulcers and less likely to delaminate than Biatain Adhesive.

[Isolated oculomotor palsy disclosing multiple myeloma]. / Paralysie oculomotrice isolée révélatrice d'un myélome multiple.

Two cases of oculomotor nerves involvement as uncommon initial manifestation of a parasellar extramedullary plasmacytoma are reported. The first patient presented with an isolated left VI cranial nerve palsy; the second one had an incomplete left III cranial nerve palsy. In both cases clinical investigation and computed tomography revealed an intracranial plasmacytoma associated with multiple myeloma. It is important to underline the difference between an intracranial extramedullary plasmacytoma and a plasmacytoma associated with multiple myeloma. In fact the absence of a general associated illness should show a most favourable course.

Cutis verticis gyrata secondary to acute monoblastic leukemia.

A 64-year-old man affected by acute monoblastic leukemia developed a cutis verticis gyrata during the terminal phase of hemopathy. The association between these two diseases is rare. The classification of cutis verticis gyrata in primary essential, primary non-essential and secondary forms is reviewed. Performing a skin biopsy is necessary in the diagnostic approach to patients with cutis verticis gyrata.

[The Lupus Band Test and serology of lupus erythematosus. Our experience]. / Lupus Band Test e sierologia nel lupus eritematoso. Nostra esperienza.

The Authors studied, from 1986 to 1988, 84 patients (24 men and 60 women, in an age group that went from 13 to 75 years, with an average of 42 years) in whom DLE was diagnosed. In these patients, a direct immunofluorescent assay was carried out on the affected skin, on the non-affected photoexposed skin, and on the non-affected non-photoexposed skin: furthermore, the serum of these patients was tested for the presence of antinuclear antibodies (ANA), antibodies to extractable nuclear antigens (anti-ENA), and antibodies to double-stranded DNA (anti-DNA). In the study, a significant correlation between the presence of ANA and entity of cutaneous involvement at the Lupus Band Test was found. Furthermore, it was noticed that anti-ENA and/or anti-nDNA tend to be present in association to a positive Lupus Band Test in all 3 biopsied tissues.

Porokeratosis palmaris et plantaris disseminata: an unusual clinical presentation.

A 54-year-old man and his son had porokeratoses of the trunk and extremities, predominantly on the palms and soles. Numerous small, slightly depressed, opalescent rings with hyperemic borders were present on the oral mucosa. The spectrum of porokeratosis palmaris et plantaris disseminata and the differential diagnosis of other types of porokeratosis are discussed.

[Linear psoriasis (linear psoriatic epidermal nevus) in a patient with HIV infection]. / Psoriasi lineare (nevo epidermico lineare-psoriasi) in paziente con infezione da HIV.

The Authors report a 24 year-old female who presented a linear localized epidermal nevus, from birth. Few months after a diagnosis of HIV infection (ARC WR 4) they observed the flaring-up of psoriasis both on the typical cutaneous sites, and on nevus, which looked like linear psoriasis.