Federica Giacomini

A double-blind, randomized, vehicle-controlled clinical study to evaluate the efficacy and safety of MAS063DP (ATOPICLAIR) in the management of atopic dermatitis in paediatric patients.

A multicenter, randomized, double‐blind, vehicle‐controlled clinical study was conducted to evaluate the efficacy and safety of MAS063DP in 60 paediatric patients affected by atopic dermatitis (AD), aged between 2 and 17 years. Using the Investigator’s Global Assessment (IGA) score for AD, patients with a score of 2 (mild) or 3 (moderate) were enrolled in the study. Patients were randomly selected to receive MAS063DP (20 patients), MAS060 (20 patients, a similar formulation with lower key ingredients’ concentration and no preservatives) or vehicle (20 patients).The study consisted in a treatment period of 43 days, with clinical evaluations at baseline (day 1), days 8, 15, 22, 29 and 43, at which time the treatment was stopped. MAS063DP showed nearly 80% improvement in IGA score at day 22, compared with 16.6% and 26.3% with the MAS060 and vehicle respectively. A statistically significant difference was found by comparing MAS063DP with MAS060 (p < 0.0001); a similar result was evidenced comparing MAS063DP and vehicle (p = 0.001). By contrast, no significant difference was found between MAS060 and vehicle. A statistically significant difference was sustained until the end of the study. MAS063DP may therefore be considered as one of the available regimens effective in the treatment of mild‐to‐moderate AD in children and adolescents.

Usefulness of dermatoscopy for the early diagnosis of sebaceous naevus and differentiation from aplasia cutis congenita

In early infancy, a congenital area of alopecia of the scalp may be the clinical presentation of various diseases, with the two most common being sebaceous naevus and aplasia cutis congenita. Typical lesions are easily diagnosed, but soon after birth, the differential diagnosis may be difficult if the clinical features of the lesion are not distinctive. In this paper, we report the usefulness of dermatoscopy in such cases.

Discoid chronic lupus erythematosus at the site of a previously healed cutaneous leishmaniasis: an example of isotopic response

The term “isotopic response” describes the occurrence of a new skin disorder at the site of another, unrelated and already healed one. We report here the case of a 38‐year‐old woman who referred to us for an infiltrated, red‐brownish plaque localized on her left cheek. The patient had been treated for a cutaneous leishmaniasis, confirmed by the histologic examination, localized at the same site. She was completely healed after an appropriate local and systemic treatment. She experienced the occurrence of the new plaque at the site of the previously healed cutaneous leishmaniasis three month later. Histologic examination and laboratory tests were consistent with a diagnosis of discoid cutaneous chronic lupus erythematosus. Treatment with hydroxychloroquine, topical clobetasol and topical tretinoin resulted in flattening and clearing of the lesion. Our case is the first case of isotopic response where a discoid chronic lupus erythematosus had occurred at the site of an already healed cutaneous leishmaniasis. We speculate that the activation of type‐1 interferon system may be involved in the pathogenesis of our case.

Targetoid hemosiderotic naevus

© 2008 The Authors JEADV 2009, 23, 441–496 Journal compilation

Acute irritant contact dermatitis due to Juglans regia.

Juglone is the active ingredient of the green flesh of walnuts and is known to be a strong irritant. We report the first two paediatric cases of contact pigmentation and acute irritant contact dermatitis due to the juice of green walnut husks in two young nursery‐school playmates.

Chronic atrophic erosive dermatosis of the scalp and atypical fibroxanthoma: a rare association

ejd.2012.1767 Auteur(s) : Francesco Savoia1,2 francesco.savoia@ausl.ra.it, Caterina Stinchi1, Lorenzo Valenti1, Laura Baldassari1, Giuseppe Gaddoni1, Federica Giacomini2, Annalisa Patrizi2, Loredana Cardinale3, Silvia Zago3 1 Unit of Dermatology, 2 Department of Internal Medicine Division of Dermatology, University of Bologna, Italy 3 Unit of Pathologic Anatomy, AUSL Ravenna, viale Dante 10, 48022 Lugo, Ravenna, Italy A 77-year-old Caucasian man, with a 10-year history of actinic keratoses treated [...]

Erythematous papules on the parasternal region in a 76‐year‐old man

A 76-year-old man presented with a diffuse eruption that had started a few months previously. He had a history of several years of muscle weakness and fatigue associated with mild joint pain and weight loss. He reported itching, abundant salivation and excessive sweating. Over several months, he had developed confusional episodes with disorientation, visual and auditory hallucinations, complex behaviour during sleep and progressive nocturnal insomnia. Before presentation to us, a diagnosis of Morvan’s syndrome had been made at the Neurological Clinical Department, University of Bologna. Physical examination revealed many erythematous papules on the trunk, especially on the parasternal region. (Fig. 1), and the patient reported mild itching and pain. An excisional biopsy was obtained from one of the lesions (Fig. 2).

Anonychia, hyponychia and spontaneous amputation of the distal phalanges as a consequence of ischaemic necrosis of the extremities after umbilical catheterization

mutation, there has been no previous report describing the development of MM in patients with a germline PTPN11 mutation. In this context, it is noteworthy that both BRAF and PTPN11 are involved in the mitogen-activated protein kinase (MAPK) cascade relevant to the development of MM. It is possible, therefore, that the somatic BRAF mutation took place in apparently normal but germline PTPN11 mutation-positive skin tissue, resulting in the development of MM because of a drastic perturbation of the MAPK signalling. This notion would explain why MM arose from an apparently naevi-free region at an old age, because such a somatic mutation would occur in both naevi-positive and -negative skin tissues in an agedependent fashion. One may argue that while the BRAF mutation activates the MAPK signalling, recent studies have shown that LS-associated PTPN11 mutations impair catalytic functions and exert dominant negative effects, in contrast to NSand neoplasiaassociated PTPN11 mutants that exert gain-of-function effects with excessive phosphatase activities. Indeed, the NSand neoplasia-associated mutations and the LS-associated mutations are mutually exclusive. However, despite the marked difference in in vitro functions of the PTPN11 mutants, LS and NS share similar clinical features, and are sometimes associated with malignant diseases such as leukaemia and neuroblastoma. Thus, NSand neoplasia-associated PTPN11 mutants and LS-associated PTPN11 mutants may have a common functional perturbation in vivo that could raise the predisposition to malignant lesions. In addition, the novel PTPN11 mutation might have a specific tumorigenic effect. Further studies will determine whether or not PTPN11 mutation-positive LS is a risk factor for the development of MM.