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1.
Dermatol Ther ; : e13334, 2020 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-32219975

RESUMO

Medication-related osteonecrosis of the jaws (MRONJ) is an infectious complication of antiresorptive or antiangiogenic drug therapies. In severe stages of this disease cutaneous sinus tracts may be observed. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate used in medicine and dentistry for to promote tissue healing. This report describes the management of facial cutaneous sinus tracts secondary to MRONJ with autologous PRF injections. Eight patients with the diagnosis MRONJ and facial sinus tracts were enrolled in this study and received treatment. MRONJ lesions underwent pharmacological and surgical treatment. Sinus tracts received 1-mL injections of PRF around the fistula using an insulin syringe once a week for four times starting from the day of the surgical treatment. After 4 weeks, six patients showed healing of the fistula and bone lesions, only one patient showed healing of the fistula, and no remission was reported in another one. All patients reported an improvement of the symptoms in the first 2 days after the treatment session. Patients were also satisfied from an aesthetic point of view. Further studies will be needed to determine if PRF is a valid therapeutic option in dermatology.

2.
Curr Drug Saf ; 15(1): 69-72, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31362662

RESUMO

BACKGROUND: Psoriasis is a cutaneous inflammatory condition characterized by an altered turnover of keratinocytes leading to scaly patches. Secukinumab and ixekizumab are two biologic drugs inhibiting interleukin-17. OBJECTIVE: We report the first case, according to Naranjo score, of a secukinumab-induced erectile dysfunction with severe plaque psoriasis that disappeared after switching to another anti IL17 drug (ixekizumab). METHODS: A 45 years old man experienced erectile dysfunction during treatment with an anti-IL17. The adverse effect appeared after 60 days of treatment with secukinumab and rapidly disappeared after discontinuation of the drug. All necessary urologic exams were carried out. Re-administration of secukinumab, due to the exacerbation of psoriasis, caused the same sexual dysfunction after 60 days. RESULTS: Switching to ixekizumab lead to a resolution of the erectile dysfunction and a complete skin clearance. CONCLUSION: We describe for the first time a sexual dysfunction possibly due to secukinumab and its resolution after the switch to another similar but different drug, highlighting the potential difference between anti-IL17A drugs.

4.
Dermatol Ther ; 33(1): e13185, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31830367

RESUMO

This study evaluates the effectiveness of the topical use of an aerosol foam combination of calcipotriol 50 µg/g plus betamethasone dipropionate 0.5 mg/g (Cal/BD foam, Enstilar®) in adults with moderate plaque psoriasis. A total of 120 male and female adult psoriasis patients (53.3% male) from two Italian dermatological units were enrolled in an 8-week prospective study performed between November 2018 and January 2019. Psoriasis Area and Severity Index (PASI) was evaluated at baseline (T0) and 4 weeks (T4) of daily application, and a further evaluation was carried out 4 weeks after suspension (T8). Furthermore, the Dermatology Life Quality Index (DLQI) was evaluated at baseline and after 4 weeks of treatment (T4). At baseline, patients presented a mean PASI of 7 (7.0 ± 2.1). After 4 weeks (T4) of once-daily application, an important improvement in PASI was observed (1.1 ± 0.3). At Week 4, DLQI was reduced by 5.5 points from baseline (mean: 12 ± 3.1 at T0 vs 6.5 ± 1.8 at T4). Four weeks after suspension (T8), mean PASI was 2.6 ± 1.9, which was stable compared to the previous evaluation; only 8.3% of the treated patients showed worsening of plaque psoriasis. This study suggested that the Cal/BD aerosol foam is an effective topical therapy to treat plaque psoriasis.

5.
Medicina (Kaunas) ; 55(9)2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31505858

RESUMO

Celiac disease (CD) is an autoimmune enteropathy that primarily affects the small intestine and is characterized by atrophy of intestinal villi. The manifestations of the disease improve following a gluten-free diet (GFD). CD is associated with various extra-intestinal diseases. Several skin manifestations are described in CD patients. The present paper reviews all CD-associated skin diseases reported in the literature and tries to analyze the pathogenic mechanisms possibly involved in these associations. Different hypotheses have been proposed to explain the possible mechanisms involved in every association between CD and cutaneous manifestations. An abnormal small intestinal permeability seems to be implicated in various dermatological manifestations. However, most of the associations between CD and cutaneous diseases is based on case reports and case series and a few controlled studies. To better assess the real involvement of the cutaneous district in CD patients, large multicentric controlled clinical trials are required.


Assuntos
Doença Celíaca/patologia , Pele/patologia , Doença Celíaca/complicações , Humanos , Dermatopatias/etiologia , Dermatopatias/patologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-31525842

RESUMO

BACKGROUND: Acne vulgaris is a chronic inflammatory disease that frequently occurs in adolescence. This common condition is often treated with topical or systemic therapies according to severity. Photodynamic therapy (PDT) with topical delta-aminolevulinic acid is a novel drugsparing, but time-consuming approach. Recently, sunlight exposure has been considered a quicker, safer, cheaper and more agreeable alternative light source for PDT, but efficacy has only been proven in the oncological field. This study aims to evaluate the efficacy and tolerability of daylight PDT (DL-PDT) for the treatment of inflammatory acne vulgaris of face, chest and trunk lesions. METHODS: Twenty patients with mild-to-moderate acne vulgaris were enrolled and treated with a topical gel based on 5% delta-aminolevulinic acid, administered 4 times at 14 day intervals. Efficacy was assessed with mean lesion count, Physician Global Assessment (PGA), Investigator's global assessment (IGA) and patients' self-assessment (10 point scale). RESULTS: Compared to T0, mean inflammatory lesions count decreased in all patients at FU1, from 16.7 ± 4.4 to 5.2 ± 3.3 (p). No adverse events were reported and no patients were lost to follow-up. PGA results of "excellent" or "good" improvement were reported in 95% at T3 and 90% at FU1. Patients' self-assessments was 7.6 ± 1.0 (T3). Discomfort was 0.5 ± 0.2 (T3 and FU1). CONCLUSIONS: DL-PDT seems to be an effective and tolerable therapy for the treatment of mildto-severe inflammatory acne. This novel regimen seems to be a viable option in the panorama of acne therapies.

8.
Dermatol Ther ; 32(5): e13042, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31361928

RESUMO

Laser is a widely accepted tool for tattoo removal, with standardized treatment protocols. Nevertheless, cosmetic tattoo removal may be challenging, because tattoos are performed in proximity of "sensitive" areas and because the ink used in cosmetic tattoos may contain substances that are not standardized and may modify their color at a high temperature. In this case series, we aim to evaluate the effectiveness of Q-switched (QS) Nd:YAG laser for cosmetic tattoo removal. Our study included 20 patients with cosmetic tattoos of lips, eyebrows, and eyeliners treated with QS Nd:YAG laser. Before treatment, an accurate preoperative assessment was performed, taking into account both patient and tattoo characteristics. Complete tattoo removal was obtained in all the cases and no major complications occurred. Adverse events were mild, mostly represented by erythema. All patients reported a high level of satisfaction. Selective photothermolysis enables complete tattoo removal, even in the case of cosmetic tattoos. However, cosmetic tattoos require a personalized treatment based on an accurate preoperative assessment which takes into account both patient and tattoo characteristics. QS Nd:YAG laser may be considered a good choice in the treatment of cosmetic tattoos, because it enables complete removal with acceptable secondary effects.

9.
Int J Immunopathol Pharmacol ; 33: 2058738419827154, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30706739

RESUMO

Metabolic diseases are chronic disorders correlated to a greater risk of cardiovascular event and death. Recently, many data have sustained the biological link between microvascular dysfunction, oxidative stress, vascular inflammation, and metabolic diseases. The determination of new and specific blood biomarkers of vascular inflammation associated with obesity-related metabolic syndrome (MetS) and diabetes such as lipoprotein-associated phospholipase A2 (Lp-PLA2) could be useful to identify subject with high risk of cardiovascular events. Lp-PLA2 participates by a crucial role in microvascular dysfunction and oxidative stress showing positive association with metabolic disorders. In this review, we will argue the evolving role of Lp-PLA2 in predicting cardiovascular events in metabolic disease patients.


Assuntos
1-Alquil-2-acetilglicerofosfocolina Esterase/metabolismo , Biomarcadores/metabolismo , Doenças Metabólicas/metabolismo , Doenças Vasculares/metabolismo , Humanos , Fatores de Risco
12.
Dermatol Ther ; 32(2): e12787, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30548724

RESUMO

Atopic dermatitis (AD) is a pruritic, chronic and inflammatory skin disease, with an usual onset in the pediatric age. Several drugs are used in the treatment of this skin disease. Drugs as steroid, calcineurin inhibitors, and moisturizing creams are widely used in the treatment of this disease but often patients are not satisfied with the obtained results. New drugs like dupilumab or crisaborole seem to be a promising option for moderate and severe forms of AD. This article analyzes the newest therapy available today for the treatment of AD.


Assuntos
Dermatite Atópica/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Satisfação do Paciente , Idade de Início , Criança , Dermatite Atópica/patologia , Fármacos Dermatológicos/farmacologia , Desenvolvimento de Medicamentos/métodos , Humanos
13.
Dermatol Ther ; 32(1): e12748, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30238580

RESUMO

Pemphigus is a group of autoimmune diseases characterized by the formation of erosions and/or flaccid bullae of the skin and/or mucosae. The definition "drug-induced pemphigus" has been coined to indicate cases of pemphigus with clinical, histological and immunopathologic features similar to those of the idiopathic disease but induced by systemic ingestion or local use of some drugs. The present authors analyzed a case series of three case reports with clinical and pharmacological features compatible with the diagnosis of angiotensin converting enzyme inhibitors or angiotensin II receptor blocker drug-induced pemphigus. The patients were visited by the dermatological Unit of Magna Graecia University in Catanzaro. All suspected drug induced pemphigus were treated by suspending the suspected drug and by starting a treatment with systemic corticosteroid drugs, leading to a remission of the clinical manifestations in some months. When a drug induced bullous disease is probable, it is necessary to interrupt the suspected substance and to start a high dose treatment with corticosteroid drugs to resolve the clinical case in a short period of time.


Assuntos
Antagonistas de Receptores de Angiotensina/efeitos adversos , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Erupção por Droga/etiologia , Pênfigo/induzido quimicamente , Pele/efeitos dos fármacos , Corticosteroides/administração & dosagem , Idoso , Erupção por Droga/diagnóstico , Erupção por Droga/tratamento farmacológico , Erupção por Droga/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pênfigo/diagnóstico , Pênfigo/tratamento farmacológico , Pênfigo/imunologia , Indução de Remissão , Pele/imunologia , Pele/patologia , Resultado do Tratamento
14.
Dermatol Pract Concept ; 8(4): 272-276, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30479854

RESUMO

Background: Topical oxygen therapy is a cosmetic procedure that is becoming more and more popular in dermatology; however, only a few articles on this topic are present in the literature. In this work we report our group experience with oxygen therapy as an adjuvant treatment in various dermatological conditions. Methods: Four studies were conducted. In the first study we used vehiculated oxygen therapy for diseases that cause hair loss. In the second study oxygen was used in the treatment of mild acne. In the third study moderate acne was treated with topical oxygen. In the fourth study chronic dermatological conditions such as psoriasis and atopic dermatitis were treated with this procedure. Results: In studies 1 and 2 the outcomes in groups who used topical oxygen therapy as an adjuvant treatment were better than in the groups that did not use it. Studies 3 and 4 also showed very good results, but no control groups were present in the study. Conclusion: Topical oxygen therapy was useful in the treatment of hair loss conditions, mild and moderate acne, and in chronic cutaneous diseases, showing effectiveness as a support therapy in all of these conditions. Further and larger studies should be conducted to better evaluate its effectiveness in dermatological conditions.

15.
Dermatol Ther ; 31(6): e12728, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30295379

RESUMO

Inverse psoriasis commonly involves skin fold areas including the axillae, perianal skin, intergluteal cleft, inframammary, genital/inguinal, abdominal, and retroauricular folds. Topical calcineurin inhibitors are indicated for the treatment of atopic dermatitis but have also been studied in the treatment of psoriasis. The object of the present study is to define the efficacy of topical calcineurin inhibitors in the treatment of psoriasis. We checked for English-vernacular articles conveyed since 1990 in PubMed, Ovid/Cochrane, and Embase using "tacrolimus," "pimecrolimus," or "topical calcineurin inhibitors," and "psoriasis" as keywords. Eight double-blind studies and seven open studies displayed the ampleness of topical tacrolimus in psoriasis. Included studies demonstrated a considerable efficacy of topical administration of tacrolimus and pimecrolimus in the treatment of psoriasis, especially for facial, genital, and intertriginous areas. The role of topical tacrolimus and pimecrolimus in the treatment of psoriasis seems to be promising as shown by the results of double-blind and open studies. Because these agents do not cause cutaneous atrophy, they have a special role in facial, genital, and intertriginous psoriatic lesions. Both agents await additional investigation to determine their roles.


Assuntos
Inibidores de Calcineurina/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Imunossupressores/administração & dosagem , Psoríase/tratamento farmacológico , Pele/efeitos dos fármacos , Tacrolimo/análogos & derivados , Administração Cutânea , Inibidores de Calcineurina/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Humanos , Imunossupressores/efeitos adversos , Psoríase/diagnóstico , Psoríase/imunologia , Pele/imunologia , Pele/patologia , Tacrolimo/administração & dosagem , Tacrolimo/efeitos adversos , Resultado do Tratamento
16.
Dermatol Ther ; 31(4): e12616, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29766626

RESUMO

Basal cell carcinoma (BCC), the most common type of skin cancer in the world, usually arises in sun-exposed areas of the skin. The therapeutic approach to periocular BCC has changed in the last few years. Currently the treatment, considering the delicate localization of the disease, must not only ensure complete recovery from the neoplastic disease, but must also satisfy functional and aesthetic criteria. In this study we tried to evaluate the efficacy of CO2 laser and photodynamic therapy in periocular BCC.


Assuntos
Carcinoma Basocelular/terapia , Neoplasias Faciais/terapia , Terapia a Laser/instrumentação , Lasers de Gás/uso terapêutico , Fotoquimioterapia , Fármacos Fotossensibilizantes/administração & dosagem , Neoplasias Cutâneas/terapia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/patologia , Quimioterapia Adjuvante , Estética , Neoplasias Faciais/patologia , Feminino , Humanos , Terapia a Laser/efeitos adversos , Lasers de Gás/efeitos adversos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Fotoquimioterapia/efeitos adversos , Fármacos Fotossensibilizantes/efeitos adversos , Neoplasias Cutâneas/patologia , Resultado do Tratamento , Carga Tumoral
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