Francesco Pastore

Acne Scars: Pathogenesis, Classification and Treatment

Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%–14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but several hypotheses have been proposed. There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, dermal grafting, needling and combined therapies for atrophic scars: silicone gels, intralesional steroid therapy, cryotherapy, and surgery for hypertrophic and keloidal lesions. This paper summarizes acne scar pathogenesis, classification and treatment options.

Regional Unemployment and Industrial Restructuring in Poland

This paper studies regional unemployment inequality in Poland. We find that regions experiencing greater change in industrial structure have higher unemployment rates. We also find that high-unemployment regions have higher inflow rates to unemployment rather than longer spells of unemployment. These findings suggest that regional unemployment varies importantly with job destruction in Poland. Econometric analysis of the determinants of employment to unemployment flows reinforces this impression. We use our estimates to assess the extent to which regional unemployment variation is due to economic restructuring. We show that this cannot be done unambiguously, and offer reasons why many previous attempts to separate out the effects of restructuring on unemployment have been unsuccessful.

Mind the Gap: Unemployment in the New EU Regions

The paper surveys the theoretical and empirical literature on regional unemployment during transition in Central and Eastern Europe. The focus is on Optimal Speed of Transition (OST) models and on comparison of them with the neoclassical tradition. In the typical neoclassical models, spatial differences essentially arise as a consequence of supply side constraints and institutional rigidities. Slow-growth, high-unemployment regions are those with backward economic structures and constraints on factors mobility contribute to making differences persistent. However, such explanations leave the question unanswered of how unemployment differences arise in the first place. Economic transition provides an excellent testing ground to answer this question. Prefiguring an empirical law, the OST literature finds that the high degree of labour turnover of high unemployment regions is associated with a high rate of industrial restructuring and, consequently, that low unemployment may be achieved by implementing transition more gradually. Moreover, international trade, FDI and various agglomeration factors help explain the success of capital cities compared to peripheral towns and rural areas in achieving low unemployment.

Relational Goods, Monitoring and Non-Pecuniary Compensations in the Nonprofit Sector: The Case of the Italian Social Services

This paper investigates the nonprofit wage gap suggesting a theoretical framework where, like in Akerlof (1984), effort correlates not only with wages, but also with non-monetary compensations. These take the form of relational goods and services by-produced in the delivery of particular services. By paying higher non-pecuniary compensations, the nonprofit sector attracts intrinsically similarly skilled, but more motivated workers, able to provide in fact a higher level of effort than their counterparts in the forprofit sector. On an empirical ground, the paper provides a number of econometric tests that confirm the main predictions of the model in Italy’s case. It adds to the available empirical literature by introducing in the analysis direct measures of non-pecuniary compensations and job satisfaction.

Resveratrol-containing gel for the treatment of acne vulgaris: a single-blind, vehicle-controlled, pilot study.

AbstractBackground: Acne vulgaris is a complex, chronic, and common skin disorder of pilosebaceous units. The major pathogenic factors involved are ductal hyperkeratinization, obstruction of sebaceous follicles resulting from abnormal keratinization of the infundibular epithelium, stimulation of sebaceous gland secretion by androgens, and microbial colonization of pilosebaceous units by Propionibacterium acnes, which promotes perifollicular inflammation. Aim: The aim of the study was to investigate the therapeutic effects of resveratrol, a natural phytoalexin produced by some spermatophytes, such as grapes and other plants, on acneic skin. Methods: Resveratrol was incorporated in a carboxymethylcellulose-based gel. The chemical stability of resveratrol after storage at 4°C for 30 days was investigated by high-performance liquid chromatography (HPLC). The resveratrol-containing hydrogel was administered to 20 patients affected by acne vulgaris enrolled in this single-blind study. The resveratrol-containing formulation was applied daily as a solo treatment on the right side of the face for 60 days, while the hydrogel vehicle was applied to the left side of the face as a control. To objectively evaluate the results, a digital photographic database was used to collect images. The number and type of lesions were recorded for each patient, to compare the Global Acne Grading System (GAGS) score before treatment with that obtained at the end of the study. Moreover, with the innovative technique of follicular biopsy, areas of acneic skin were prepared for histopathology. The average area occupied by microcomedones at baseline was compared with that at the end of treatment. Results: HPLC analysis demonstrated that resveratrol, upon incorporation into the gel, did not convert to its cis-isomer when stored at 4°C for 30 days. All patients were satisfied with the active treatment and none experienced adverse effects. Clinical evaluation showed a 53.75% mean reduction in the GAGS score on the resveratrol-treated sides of the face compared with 6.10% on the vehicle-treated sides of the face. These data were supported by histologic analysis, which showed a 66.7% mean reduction in the average area of microcomedones on the resveratrol-treated sides of the face. The comparison with the vehicle-treated side of the face (9.7% reduction) showed a clinically relevant and statistically significant decrease of lesions in areas treated with resveratrol-containing hydrogel. Conclusion: This pilot study showed positive results for resveratrol gel in acne, and should be considered a valid starting point for further testing of the effectiveness of this molecule in different concentrations and formulations and in a larger group of patients.

The Labour Market Impact of the EU Enlargement

Until recently, regional labour market imbalances were considered transitory phenomena, a consequence of state failure in generating distorted investment incentives in depressed regions as well as of excessive labour market rigidities. Labour mobility and wage flexibility were at the core of the debate over the causes of and cures for regional labour market imbalances. This book bears witness to the changed perspective of research on these issues. In the recent literature, internal labour migration is depicted as a cause of further divergence between advanced and backward regions, as higher returns on human and physical capital are expected to be paid in those regions where these factors are already concentrated. The book contributes to the debate by presenting important new findings on: a) the reasons why structural change in some sectors causes a slump in some regions, but not in others; b) the extent to which poverty traps explain regional imbalances as compared to such other alternative factors as spatial dependence and nonlinearity in growth behaviour; c) the degree of convergence across EU countries and regions; d) the role of labour mobility in reducing/increasing regional labour market imbalances, in particular in Central and Eastern Europe; e) the role of an active labour market policy and child care facilities in alleviating the hardship of the weakest segments of the population.

When Does Transition Increase the Gender Wage Gap

This paper suggests an analytical framework to analyse the joint evolution of female participation and wages across countries in Central and Eastern Europe (CEE) and the Former Soviet Union (FSU), of which Belarus is a particular case. In CEE, female participation has reduced relatively more than wages, due to greater wage rigidity; in the FSU, wages have reduced more than participation, due to labour hoarding practices. In Belarus, only wages adjust, since (mainly state owned) firms tend to largely maintain their entire workforce. Underneath slow transition and remarkably stable female participation rates (at over 80%), the unconditional gender gap in log hourly wages has increased by a half, while that in log of net and total monthly wages has more than doubled over almost a decade (1996-2004). The Juhn, Murphy and Pierce (1991) decomposition suggests that the deterioration of women wages is caused by negative changes in observed characteristics (due to horizontal segregation) and in the remuneration for those characteristics. Instead, very bland changes in the residual wage distribution tended to reduce (not to increase) the gender wage gap: in fact, women have benefited both of changes in the degree of wage inequality and of gains in the mean female rank in the male residual distribution.

The effect of aminolevulinic acid photodynamic therapy on microcomedones and macrocomedones.

Background: Photodynamic therapy (PDT) with aminolevulinic acid (ALA) has been shown to be an effective treatment for acne. However, the effect of ALA PDT on comedo formation has never been objectively evaluated. Cyanoacrylate follicular biopsy (CFB), a noninvasive procedure, has been proposed as the most reliable tool for studying follicular casts. Objective: To determine the possible effect of ALA and red light (550–700 nm) on macro- and microcomedones in acne patients. Patients and Methods: 10 patients with mild-to-moderate facial and/or chest/back acne resistant to conventional therapies received ALA PDT at 2-week intervals in 3 sessions. The severity of acne had been estimated by a system of points, the Global Acne Grading System. The patients underwent PDT utilizing ALA 10% (face) or 15% (back/chest) and red light (15 J/cm2 each session). CFBs were performed. Results: Four weeks after their last PDT session, the patients showed an average global score reduction of 50%. CFBs demonstrated a reduction in the total area, the average area and the density of macrocomedones. Conclusion: The results obtained in this study using CFB evaluation demonstrate that ALA PDT exerts an action on the comedogenic phase as well.

CROSS technique: chemical reconstruction of skin scars method

ABSTRACT:  Skin scars remain a therapeutic challenge to dermatologists. Over the past several decades, numerous surgical techniques have been used to improve the appearance of scarring. The objective of this study is to evaluate the efficacy of a local application of a (50%) concentration of trichloroacetic acid (TCA) for the treatment of atrophic acne scars (grade 3 in Goodman classification), as opposed to the higher (90%) TCA concentration used in previous studies, in order to reduce adverse local effects. The primary goal was the resolution of acne or chickenpox scars. Secondary goals were physician and subject assessments of scar improvement. Fifty percent TCA was applied locally to atrophic scars in five patients. Three patients had treated scars on the face and two patients had treated scars on the back. Wooden applicators were used to apply TCA locally and the treatment was repeated at 4‐week intervals for a total of three sessions. Digital photographic analysis of lesions supported clinical observations. Histologic examination was performed only on two samples of patients with treated scars on the back. Clinical examination revealed cosmetic improvements in both depth and appearance of skin scars. We believe that the 50% TCA CROSS can be an effective technique for the treatment of atrophic scars.

Epidemiology of skin cancer: role of some environmental factors.

The incidence rate of melanoma and non-melanoma skin cancer entities is dramatically increasing worldwide. Exposure to UVB radiation is known to induce basal and squamous cell skin cancer in a dose-dependent way and the depletion of stratospheric ozone has implications for increases in biologically damaging solar UVB radiation reaching the earth’s surface. In humans, arsenic is known to cause cancer of the skin, as well as cancer of the lung, bladder, liver, and kidney. Exposure to high levels of arsenic in drinking water has been recognized in some regions of the world. SCC and BCC (squamous and basal cell carcinoma) have been reported to be associated with ingestion of arsenic alone or in combination with other risk factors. The impact of changes in ambient temperature will influence people’s behavior and the time they spend outdoors. Higher temperatures accompanying climate change may lead, among many other effects, to increasing incidence of skin cancer.