Caterina Mazzella

Enhanced antioxidant effect of trans-resveratrol: potential of binary systems with polyethylene glycol and cyclodextrin

Abstract Trans-resveratrol, a polyphenol extracted from Vitis vinifera, has different beneficial effects following its administration on the skin. Here the potential use of binary systems to enhance in vitro and in vivo activity of trans-resveratrol was investigated. Thus the aqueous solubility of trans-resveratrol was investigated in the presence of growing concentrations of polyethylene glycol (PEG) or β-cyclodextrin (βCD) as solubilizing excipients. Then, the solid dispersion of trans-resveratrol with PEG or inclusion complexes trans-resveratrol/βCD were prepared and characterised by different methods. Cytotoxicity and inhibition of reactive oxygen species (ROS) following H2O2 challenge in the presence of trans-resveratrol, alone or associated to the excipients, was evaluated on human keratinocyte HaCaT cell line. Both the trans-resveratrol-containing binary systems induced significant reduction of H2O2-induced ROS production, especially in the case of βCD that was selected for the following phase of the study. Thus, the effect of a cream containing trans-resveratrol, alone or associated to βCD, on different skin parameters such as corneometry, colorimetry and elastometry, was evaluated on human volunteers. All patients showed a visible improvement of clinical conditions with a remarkable decrease of aging signs, but this effect was higher of the hemi face treated with the βCD-containing formulation versus formulation containing trans-resveratrol alone.

Teledermatology: from prevention to diagnosis of nonmelanoma and melanoma skin cancer

Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred through interactive audiovisual media for the purpose of consulting remote medical procedures or examinations, reducing the time of consultation for patients. Teledermatology as an application of telemedicine was developed in 1995: it turns out to be a gradually more ordinary mean of delivering dermatologic healthcare worldwide and will almost certainly have a greater medical function in the future. In particular, teledermatology can aid in the prevention and diagnosis of nonmelanoma and melanoma skin cancer; telemedicine and teledermatology offer the opportunity to make available consultations with experts also by long distance. Overall, patients seem to accept teledermatology, considering it as an excellent mean to obtain healthcare, particularly in those areas with no expert dermatologists available. Clinicians have also generally reported affirmative experiences with teledermatology in the skin cancer field. Further studies focusing on cost effectiveness, patient outcomes, and patient and clinician satisfaction will facilitate to delineate the potential of teledermatology as a mean of prevention and diagnosis of nonmelanoma and melanoma skin cancer.

Sunbathing and sunlamp exposure: awareness and risk among Italian teenagers.

To the Editor, Adolescence represents a critical period of life during which ultraviolet (UV) radiation can increase skin cancer risk. ‘Tanorexia’ is a new term used to describe an intense desire to be tanned, that multiple studies have tried to classify as a dysmorphic disorder, deriving from an obsessive and distressing desire to be suntanned (1).According to Molly M.Warthan et al. (2), we consider tanorexia as the repetitive behavior of an individual with regard to UV exposure.We have analyzed attitudes to indoor tanning among young people aged from 16 to 19, selected from a high school in Naples (Italy) to identify the risk of this disorder among Italian adolescents.

The Management of Atrophic Acne Scars: Overview and New Tools

Acne is a common disorder with a high prevalence among adolescents. Acne can cause atrophic scars that are a very unpleasant marker and it may have a negative psychological impact on social life and relationships. The distress generated by acne scars is sometimes very strong among adolescents. General dermatologists have, often, the key role to evaluate atrophic scars and to suggest different treatments. The aim of this paper is to review the different therapeutic options for atrophic scars such as chemical peels, tretinoin-iontophoresis, dermabrasion/microdermabrasion, tissue augmentation, laser treatment, punch excision techniques, subcision, and percutaneous collagen induction by skin needling.

Reflectance Confocal Microscopy as New Diagnostic Tool in Folliculotropic Mycosis Fungoides

We present a case of folliculotropic mycosis fungoides (FMF), a variant of cutaneous T-cell lymphoma which particularly affects hair follicles. FMF can imitate a wide variety of otherwise benign dermatoses, so it poses major diagnostic obstacles both for the dermatologist as well as the dermatopathologist. In our case, in vivo reflectance confocal microscopy (RCM) was very important for guiding the skin biopsy site selection. For this reason, RCM can reduce the number of unsuccessful histopathological examinations and increase the diagnostic accuracy for different skin dermatoses.

Confocal microscopy can assess the efficacy of combined microneedling and skinbooster for striae rubrae

ABSTRACT Striae distensae or stretch marks are dermal scars characterized by flattening and atrophy of the epidermis. They develop particularly during adolescence but they can also appear in other situations such as pregnancy, the use of prolonged therapies with topical or systemic corticosteroids, Cushing’s syndrome, Marfan’s syndrome, prolonged use of lightening creams, cachexia, rapid weight loss or the use of androgenic and anabolic substances. Treatment options often take a long time, and the results are often disappointing, causing significant psychological distress in patients. We propose a completely innovative approach, combining the skinbooster technique with the microneedling technique. These minivasive methods work by inducing tissue remodeling and stimulating the synthesis of new collagen. Confocal microscopy can show and follow the skin changes made by these therapies, thus becoming an important and valid therapeutic monitoring tool for aesthetic dermatology.

Instrumental, clinical and subjective evaluation of the efficacy of a cosmetic treatment for home use

ABSTRACT Background: In the last few years, there has been increasing demand for aesthetic procedures to improve the effects of skin aging. Aim: To evaluate the anti-aging efficacy, tolerability and skin changes induced by the topical products containing hyaluronic acid, N-acetyl glucosamine and gamma-amino butyric acid through instrumental techniques, clinical and subjective evaluation. Patients/Method: Twenty female enrolled applied a day and night cream after applying a serum, once week applied a mask, for 2 months. A clinical assessment of smoothness, expression wrinkles, fine wrinkles and measurements of the parameters using Reveal Imager, X-Rite, Corneometer, Dermalab, Moisture Meter EpiD were taken at day 0, 15, 30 and 60 of study period. A final assessment questionnaire was submitted. Results: The products were accepted by all the volunteers. The hydration (Corneometer: T0 49.17 vs T60 61.11, average variation 24.28%) (Moisture Meter EpiD: T0 45.73 vs T60 61.10, average variation 33.60%), elasticity (Dermalab: T0 56.06 vs T60 62.78, average variation 11.98%) and lightening of the skin (X-Rite: T0 60.23 vs T60 63.36, average variation 5.26%) improved. All changes were statistically significant (p < 0.05). Conclusion: The efficacy of the topical products is confirmed by subjective, clinical and instrumental assessment. This should be a routine approach in dermatologic practice.

Difficult to diagnose small cutaneous melanoma metastases mimicking angiomas: utility of dermoscopy

Metastases from melanoma can be found in any organ, while the reported incidence of skin metastases varies between 2 and 20%. Cutaneous melanoma metastases (CMM) can be heterogeneous at clinical examination, and they can simulate other benign and malignant lesions, thus generating major diagnostic troubles for the dermatologist. Dermoscopy is a useful tool that may increase the physicians diagnostic accuracy to this purpose.

Management of clinical and subclinical actinic keratoses with histological and immunohistochemical assessments by confocal microscopy

Reflectance confocal microscopy has been used to monitor treatment efficacy in non‐melanoma skin cancer, but few studies have compared different therapies using the same confocal criteria. We compare a single score designed in previous study to evaluate confocal, histological, and immunohistochemical results obtained before and after two treatments of actinic keratosis (AK) and in field cancerisation area. Thirty volunteer male patients, aged >50‐year old, with at least three clinically visible AKs on the bald scalp, were included in this study: 15 patients were submitted to 3% diclofenac therapy and 15 to 5% fluorouracil therapy. Confocal imaging was performed on a 5 × 5 cm skin area. In five patients of each group we performed cutaneous biopsies. Scaling, upper nucleated cells, and inflammatory cells showed a higher percentage reduction in field cancerisation, especially in diclofenac treatment group, while in AK inflammatory cells showed a greater percentage reduction in 5‐fluorouracil treatment group. Both therapies are efficacious, but their effectiveness is different on the single parameters of the confocal, histology, immunohistochemically.

Confocal microscopy and imaging profilometry: A new tool aimed to evaluate aesthetic procedures

According to the American Academy of Aesthetic Plastic Surgeons, more than 11 million cosmetic surgical and nonsurgical procedures were performed by board-certified plastic surgeons, dermatologists and otolaryngologists in the United States, totaling more than 12 billion dollars. We performed a retrospective observational multi-centric study on patients treated with a non-animal origin cross-linked hyaluronic acid with different molecular weights for nasolabial folds, evaluating through a new imaging system, profilometric techniques with the confocal microscopy, the durability, the efficacy and the safety of this product. From 25 patients, 150 silicone casts were obtained: 75 casts of the right nasolabial fold and 75 casts of the left nasolabial fold. Roughness arithmetical average of the right fold at T2 decreased by 50% versus T0 and by 40% compared to T1; at T2, it decreased by the 45% versus T0 and by 35% compared to T1. No side effects were reported. Results proved that the analysis of the skin microreliefs through confocal microscopy is a new imaging system that allows to evaluate with precision and safety the results of aesthetic treatments such as fillers objectively.