Barbara Marconi

Effect of Allium Cepa-Allantoin-Pentaglycan Gel on Skin Hypertrophic Scars: Clinical and Video-Capillaroscopic Results of an Open-Label, Controlled, Nonrandomized Clinical Trial

BACKGROUND Hypertrophic scar formation is a process in which prolonged angiogenesis sustained by vascular endothelial growth factor cutaneous expression plays an important role. OBJECTIVE This in vivo study was conducted to evaluate the clinical effect of a topical gel containing onion extract, allantoin, and pentaglycan on hypertrophic scars and keloids. MATERIALS AND METHODS Thirty people with hypertrophic scars or keloids were examined. Fifteen patients received a topical application of a gel containing allium cepa, allantoin, and pentaglycan twice a day for 24 weeks, the remaining 15 patients received no topical treatments. A clinical evaluation and an intravital videocapillaroscopy were performed on every patient at baseline (T0) and 24 weeks (T24) after the treatment. RESULTS Only the patients who received the topical treatment showed a significant reduction in neoangiogenetic features, demonstrated through an improvement of erythema and all videocapillaroscopic markers of neoangiogenesis. These changes induced by therapy led to a general improvement of the lesions. CONCLUSION Topical applications of a gel containing allium cepa, pentaglycan, and allantoin twice a day for 24 weeks seems to be useful in reducing neoangiogenesis in hypertrophic scars and keloids, resulting in clinical improvement of skin lesions. The authors have indicated no significant interest with commercial supporters.

Lichen striatus in adults and pimecrolimus: open, off‐label clinical study

Background  Lichen striatus is a well‐known, acquired, self‐healing, linear inflammatory dermatosis. Lichen striatus occurring in adults tends to be more extensive and itchy than in children, sometimes requiring symptomatic treatment. The therapeutic approach usually adopted is topical steroids, even though prolonged use may lead to several side‐effects, particularly cutaneous atrophy.

Pseudoxanthoma elasticum and skin: Clinical manifestations, histopathology, pathomechanism, perspectives of treatment.

Pseudoxantoma elasticum (PXE), also known as Groenblad-Strandberg syndrome, is a rare heritable disease with an estimated prevalence of 1:50,000 in the general population. PXE is considered a prototype of multisystem ectopic mineralization disorders and it is characterized by aberrant mineralization of soft connective tissue with degeneration of the elastic fibers, involving primarily the eyes, the cardiovascular system, and the skin. Cutaneous lesions consist of small, asymptomatic, yellowish papules or larger coalescent plaques, typically located on the neck and the flexural areas. PXE is caused by mutations in the ABCC6 (ATP-binding cassette subfamily C member 6) gene that encodes a transmembrane ATP binding efflux transporter, normally expressed in the liver and the kidney; however, the exact mechanism of ectopic mineralization remains largely unknown. The histological examination of cutaneous lesions, revealing accumulation of pleomorphic elastic structures in middermis, is essential for the definitive diagnosis of PXE, excluding PXE-like conditions. PXE is currently an intractable disease; although the cutaneous findings primarily present a cosmetic problem, they signify the risk for development of ocular and cardiovascular complications associated with considerable morbidity and mortality. The purpose of this review is to present a comprehensive overview of this rare form of hereditary connective tissue disorders, focus on the pathogenesis, the clinical manifestation, and the differential diagnosis of PXE. Emphasis is also placed on the management of cutaneous lesions and treatment perspectives of PXE.

A case of hypertrophic lichen ruber planus of the leg complicated by a squamous cell carcinoma.

A case of hypertrophic lichen ruber planus of the leg complicated by a squamous cell carcinoma In November 2000, a 58-year-old man suffering from longstanding (20 years) and histologically documented hypertrophic lichen planus (LP) of the legs (Fig. 1), with no other additional cutaneous or mucosal involvement, was referred for the evaluation of the development of an exophytic neoformation within the context of an LP skin lesion. After a physical examination, a 3 × 2-cm, well-outlined, easily bleeding verrucous nodule was evident over a plaque of hypertrophic LP located in the pretibial area of the right leg (Fig. 2). No history of arsenicals, ionizing radiation treatment, topical application of coal tar, or systemic administration of immunosuppressive drugs was found; the patient had stopped topical application of corticosteroids 12 months before the tumor appeared. Wide surgical excision of the cutaneous lesion was performed. Within the context of the LP plaque, a cutaneous neoplastic proliferation of large, polygonal, keratinizing, welldifferentiated, abnormally oriented squamous cells, with deep dermis invasion, was evident. The tumor presented rare atypical mitoses and areas of maturation forming parakeratotic horny pearls. On immunohistochemical evaluation, proliferating markers showed a variable grade of staining: monoclonal antibodies against monoclonal mouse antiproliferating cell nuclear antigen (PCNA) stained more than 70% of deeper invading neoplastic cells. High proliferating malignant cells of the nodular component reacted strongly with monoclonal mouse anti-human ki67 antigen (Mib-1), whose expression dramatically decreased between the tumor and LP lesion. Rare atypical mitoses, located in the deep, more aggressive part of the neoplasm, were labeled by p53 with strong expression. A diagnosis of well-differentiated squamous cell carcinoma (SCC) associated with hypertrophic LP was made.

Treatment of focal idiopathic hyperhidrosis with Botulinum Toxin Type A: clinical predictive factors of relapse‐free survival

Background  No material about the identification of predictive clinical factors of therapeutic response to Botulinum Toxin Type A (BTX‐A) in focal idiopathic hyperhidrosis has been found.

A non‐responsive chronic autoimmune urticaria in a 12‐year‐old autistic girl treated with cyclosporin

© 2008 The Authors JEADV 2009, 23, 570–620 Journal compilation

A case of pretibial myxoedema associated to ectopic secreting thyroid nodule on thyroglossal duct residue

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