Eleni Sotiriou

Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea

Background  Dermoscopy is useful in evaluating skin tumours, but its applicability extends also to the field of inflammatory skin disorders. Plaque psoriasis (PP), dermatitis, lichen planus (LP) and pityriasis rosea (PR) are common inflammatory skin diseases, but little is currently known about their dermoscopic features.

Photodynamic therapy for distal and lateral subungual toenail onychomycosis caused by Trichophyton rubrum: Preliminary results of a single-centre open trial.

. A combination of topical and systemic thera-pies seems to be the ideal approach in the treatment (1). However, as many patients have conditions that contra-indicate the administration of systemic anti-fungals, and as topical treatments alone are able to control cases of only mild to moderate severity, it is necessary to develop new safe and effective strategies for the treatment of onychomycosis. The use of photodynamic therapy (PDT) has ex-tended in many fields, including that of antimicrobial chemotherapy (1).

Skin cancer: preventive photodynamic therapy in patients with face and scalp cancerization. A randomized placebo-controlled study.

Background  Patients with a previous medical history of nonmelanoma skin cancers (NMSCs) often develop multiple or recurrent malignant lesions around the site of the primary tumour. This finding led to the field cancerization theory, which suggests that the entire epithelial surface of the regional skin has an increased risk for the development of malignant lesions. Management of field change is challenging, taking into account the high impact of NMSCs on public health and healthcare costs.

Intraindividual, right–left comparison of topical 5-aminolevulinic acid photodynamic therapy vs. 5% imiquimod cream for actinic keratoses on the upper extremities

Backround  Actinic keratoses (AKs) are considered as in situ squamous cell carcinoma. Early and effective treatment is important.

Febrile ulceronecrotic Mucha-Habermann disease: a case report and review of the literature.

Febrile ulceronecrotic Mucha-Habermann disease is a severe variant of pityriasis lichenoides et varioliformis acuta characterized by the sudden onset of ulceronecrotic skin lesions and associated with high fever and systemic symptoms. We report here a case of a 20-year-old woman in whom the disease started as pityriasis lichenoides et varioliformis acuta and evolved to febrile ulceronecrotic Mucha-Habermann disease. Almost 90% of the body surface was involved, together with high fever and malaise. Steroids alone proved to be an insufficient therapeutic procedure. The remission achieved was attributed to the use of methotrexate. To our knowledge, only 39 cases of febrile ulceronecrotic Mucha-Habermann disease have been reported in the literature to date.

Dermoscopy of early stage mycosis fungoides

Background  Early stage mycosis fungoides (MF) is difficult to be clinically differentiated from chronic dermatitis (CD) in a high proportion of patients. Dermoscopy is a rapid, cheep, non‐invasive and widely used method for the evaluation of skin tumours and, recently, of inflammatory skin diseases, as well.

Spontaneous abortion during ustekinumab therapy

BACKGROUND Psoriasis affects a considerable proportion of women in their reproductive years. Limited published data exist about the possible negative impact of the disease itself in the prognosis of pregnancy. On this background, the emergence of newer biologic agents for psoriasis treatment - such as ustekinumab - raises safety issues concerning the exposure to the drug during pregnancy. To our knowledge this is the first report in the literature describing a pregnancy outcome under ustekinumab treatment. OBSERVATION We report a 35-year-old female psoriasis patient who was under treatment with ustekinumab for a year when she inadvertedly became pregnant. The drug was discontinued immediately and the patient did not opt for termination. During the 12th week of gestation she experienced a spontaneous abortion. CONCLUSION Although the patients profile fulfilled 2 general risk factors for spontaneous abortion - she was a smoker and this was her third pregnancy - one could not underestimate the possible role of the drug and of psoriasis per se in this adverse pregnancy outcome. Pregnancy registries and large prospective studies are needed in order to determine whether poorer pregnancies outcomes in psoriatic women are due to the disease itself, associated comorbidities or side-effects of new therapies such as ustekinumab.

Dermoscopy of discoid lupus erythematosus

Summary Background  Dermoscopy is useful in evaluating skin tumours, but its applicability also extends into the field of inflammatory skin disorders. Discoid lupus erythematosus (DLE) represents the most common subtype of cutaneous lupus erythematosus. While dermoscopy and videodermoscopy have been shown to aid the differentiation of scalp DLE from other causes of scarring alopecia, limited data exist concerning dermoscopic criteria of DLE in other locations, such as the face, trunk and extremities.

Actinic cheilitis treated with one cycle of 5‐aminolaevulinic acid‐based photodynamic therapy: report of 10 cases

neous inflammatory processes: an overview. Br J Dermatol 1983; 109 (Suppl. 25):89–98. 4 Cliff S, Bedlow AJ, Stanton AW, Mortimer PS. An in vivo study of the microlymphatics in psoriasis using fluorescence microlymphography. Br J Dermatol 1999; 140:61–6. 5 Ryan TJ. Microcirculation in psoriasis: blood vessels, lymphatics and tissue fluid. Pharmacol Ther 1980; 10:27–64. 6 Bacharach-Buhles M, El-Gammal S, Panz B, Altmeyer P. In psoriasis the epidermis, including the subepidermal vascular plexus, grows downwards into the dermis. Br J Dermatol 1997; 136:97–101. 7 Kahn HJ, Marks A. A new monoclonal antibody, D2-40, for detection of lymphatic invasion in primary tumors. Lab Invest 2002; 82:1255–7. 8 Kahn HJ, Bailey D, Marks A. Monoclonal antibody D2-40, a new marker of lymphatic endothelium, reacts with Kaposi’s sarcoma and a subset of angiosarcomas. Mod Pathol 2002; 15:434–40. 9 Jackowski S, Janusch M, Fiedler E et al. Radiogenic lymphangiogenesis in the skin. Am J Pathol 2007; 171:338–48. 10 Staberg B, Klemp P, Aasted M et al. Lymphatic albumin clearance from psoriatic skin. J Am Acad Dermatol 1983; 9:857–61. 11 Davison SC, Ballsdon A, Allen MH, Barker JN. Early migration of cutaneous lymphocyte-associated antigen (CLA) positive T cells into evolving psoriatic plaques. Exp Dermatol 2001; 10:280–5. 12 Braun-Falco O, Christophers E. Structural aspects of initial psoriatic lesions. Arch Dermatol Forsch 1974; 251:95–110. 13 Braverman IM, Sibley J. Role of the microcirculation in the treatment and pathogenesis of psoriasis. J Invest Dermatol 1982; 78:12– 17. 14 Staberg B, Worm AM, Klemp P, Rossing N. Transvascular transport and distribution of fluid and protein in psoriasis. J Am Acad Dermatol 1983; 8:193–9.

The impact of different fluence rates on pain and clinical outcome in patients with actinic keratoses treated with photodynamic therapy.

Background/purpose: Literature data suggest that lower fluence rates are preferable in terms of clinical response and tolerability for treating patients with actinic keratoses (AKs). We aimed to clarify the impact of different fluence rates on pain during photodynamic therapy (PDT) for AKs, as well as on treatment outcome.