History of syphilis: between poetry and medicine.

INTRODUCTION: The origin of syphilis is a matter of debate and two "historical" hypotheses explain its emergence. AIM: We present here a review about syphilis history. METHODS: A review of literature about syphilis history using the following keywords: "syphilis," "history," and "treponema." RESULTS: The Columbian opinion is that syphilis came from the New World (America) with the crews of Christopher Columbus's fleet. As Naples fell before the invading army of Charles the VIII in 1495, a plague broke out among the French leader's troops. When the army disbanded shortly after the campaign, the troops, composed largely of mercenaries, returned to their homes and disseminated the disease across Europe. Indeed, there were reports that indigenous peoples of the New World suffered from a similar condition. CONCLUSION: Regardless of the Columbian and the Pre-Columbian theories, syphilis remains an international disease, growing nowadays with HIV infection. Despite history, politics, paleopathology and molecular approaches, the origin of the disease remains an enigma.

Efficacy and Safety of 10,600-nm Carbon Dioxide Fractional Laser on Facial Skin with Previous Volume Injections.

BACKGROUND: Fractionated carbon dioxide (CO2) lasers are a new treatment modality for skin resurfacing. The cosmetic rejuvenation market abounds with various injectable devices (poly-L-lactic acid, polymethyl-methacrylate, collagens, hyaluronic acids, silicone). The objective of this study is to examine the efficacy and safety of 10,600-nm CO2 fractional laser on facial skin with previous volume injections. MATERIALS AND METHODS: This is a retrospective study including 14 patients treated with fractional CO2 laser and who have had previous facial volume restoration. The indication for the laser therapy, the age of the patients, previous facial volume restoration, and side effects were all recorded from their medical files. Objective assessments were made through clinical physician global assessment records and improvement scores records. Patients' satisfaction rates were also recorded. RESULTS: Review of medical records of the 14 patients show that five patients had polylactic acid injection prior to the laser session. Eight patients had hyaluronic acid injection prior to the laser session. Two patients had fat injection, two had silicone injection and one patient had facial thread lift. Side effects included pain during the laser treatment, post-treatment scaling, post-treatment erythema, hyperpigmentation which spontaneously resolved within a month. Concerning the previous facial volume restoration, no granulomatous reactions were noted, no facial shape deformation and no asymmetry were encountered whatever the facial volume product was. CONCLUSION: CO2 fractional laser treatments do not seem to affect facial skin which had previous facial volume restoration with polylactic acid for more than 6 years, hyaluronic acid for more than 0.5 year, silicone for more than 6 years, or fat for more than 1.4 year. Prospective larger studies focusing on many other variables (skin phototype, injected device type) are required to achieve better conclusions.

Depilatory laser: a potential causative factor for inguinal hyperhidrosis: report of three cases.

Hyperhidrosis has recently been described as a novel adverse effect of laser-assisted hair removal in the axillary area. Inguinal Hyperhidrosis (IH) is a localized and, typically, a primary form of hyperhidrosis affecting the groin area in individuals before age 25. IH has been reported in the literature after traumas and as a dysfunction of the central sympathetic nervous system. To the best of our knowledge, IH has never been reported as secondary to laser-assisted hair removal. Herein, we report three cases of IH following depilatory laser of the inguinal zone. Three female patients with no relevant medical history presented with the complaint of excessive sweating in the inguinal area after undergoing full bikini depilatory laser sessions. Although never described before, depilatory laser seems to trigger the occurrence of hyperhidrosis in the inguinal zone.

Fox-Fordyce-like disease following laser hair removal appearing on all treated areas.

Fox-Fordyce disease is an uncommon inflammatory disease of the apocrine sweat glands. Two recent reports indicated laser hair removal as a novel cause of axillary Fox-Fordyce disease. We report the first case of Fox-Fordyce disease developing in women after completing treatment with a depilatory hair laser appearing in the axillae, umbilicus, and pubis. We describe a case of Fox-Fordyce disease that developed in a 27-year-old woman 3 months after she had completed two LightSheer Diode laser treatments of her axilla, periumbilical region, and bikini area. Clinical and histopathological changes are as well detailed. Laser therapy induces damage to follicular infundibulum, resulting in altered maturation of keratinocytes which led to keratin plugging causing the common pathologic features in Fox-Fordyce disease. Differences in the physiologic features of the anatomic sites, in the susceptibility to laser-induced injury among these areas, or additional factors may contribute to Fox-Fordyce disease.

Raynaud's phenomenon and vitamin D.

To our knowledge, there have not been studies to evaluate the effect of vitamin D supplementation on Raynaud's phenomenon (RP). To test in a randomized, placebo-controlled, double blind, and prospective way whether 8 weeks of 600,000 IU monthly supplementation of oral vitamin D3 would contribute to improvements in RP, 53 patients describing RP were recruited during winter 2010-2011. 42 patients were deficient in vitamin D dosage and randomly assigned into either the vitamin D group or placebo group. Every 4 weeks (for a total of 3 doses), patients received their treatment and answered on a visual analogue scale (VAS) basis about their RP. In the vitamin D group, baseline average blood vitamin D level was 20.9 ng/mL. VAS 0, VAS 1, and VAS 2 were 58.33, 48.09, and 36.2, respectively. At the end of the study, the average blood vitamin D level was 32.9 ng/mL. In the placebo group, baseline average blood vitamin D level was 21.8 ng/mL. VAS 0, VAS 1, and VAS 2 were 58.33, 51.19, and 64.28, respectively. At the end of the study, the average blood vitamin D level was 23.2 ng/mL. Following our observations, we concluded to an objective augmentation of vitamin D blood level and RP self-judgment improvement after 8 weeks of monthly supplementation of vitamin D3. One can ask whether vitamin D has as a vasodilator effect in patients with RP who are deficient in vitamin D. Other studies and researches are needed to answer these questions.

Treatment of nodular basal cell carcinoma with cryotherapy and reduced protocol of imiquimod.

Various treatment options are available for basal cell carcinoma (BCC). We report a case of a patient with a nodular BCC on the nose who was treated with combination therapy consisting of cryotherapy with liquid nitrogen followed by imiquimod cream 5% 5 times weekly for 6 weeks. Clearance of the lesion was histologically confirmed.