Giuseppe Micali

Familial keratosis follicularis spinulosa decalvans associated with woolly hair.

Keratosis follicularis spinulosa decalvans (KFSD) is a rare inherited disorder of keratinization clinically characterized by diffuse follicular hyperkeratosis, progressive scarring alopecia of scalp, eyebrows and eyelashes, corneal dystrophy and photophobia. Woolly hair is a hereditary condition, transmitted as an autosomal dominant or recessive trait, usually seen in Caucasians at birth or shortly after, in which there are curly, thick, often heavily pigmented hairs.

Superficial cutaneous Trichosporon asahii infection in an immunocompetent host

A 16‐year‐old schoolgirl presented with a complaint of enlarging erythematous and mildly pruritic patches located on the buttocks of 2 years’ duration. She had been treated with a potent topical corticosteroid for many months without apparent benefit. She was in otherwise good health. She denied a history of hair infection, previous eruptions, asthma, or hay fever. No one in her family or friends had similar lesions. She had no pets in her house.

Treatment of Seborrhoeic Dermatitis in Asia: A Consensus Guide

Seborrhoeic dermatitis (SD) is common in Asia. Its prevalence is estimated to be 1-5% in adults. However, larger population-based studies into the epidemiology of SD in Asia are lacking, and the aetiology of SD may differ widely from Western countries and in different parts of Asia. In addition, clinically significant differences between Asian and Caucasian skin have been reported. There is a need to define standardized clinical diagnostic criteria and/or a grading system to help determine appropriate treatments for SD within Asia. With this in mind, experts from India, South Korea, Taiwan, Malaysia, Vietnam, Singapore, Thailand, the Philippines, Indonesia, and Italy convened to define the landscape of SD in Asia at a meeting held in Singapore. The consensus group developed a comprehensive algorithm to aid clinicians to recommend appropriate treatment of SD in both adults and children. In most cases, satisfactory therapeutic results can be accomplished with topical antifungal agents or topical corticosteroids. Non-steroidal anti-inflammatory agents with antifungal properties have been shown to be a viable option for both acute and maintenance therapy.

Noncorticosteroid Combination Shampoo versus 1% Ketoconazole Shampoo for the Management of Mild-to-Moderate Seborrheic Dermatitis of the Scalp: Results from a Randomized, Investigator-Single-Blind Trial Using Clinical and Trichoscopic Evaluation.

Purpose: The aim of this study was to assess the efficacy and tolerability of a combination noncorticosteroid, antiinflammatory/antifungal shampoo versus 1% ketoconazole shampoo in the treatment of mild-to-moderate scalp seborrheic dermatitis (SD). Procedures: Twenty patients were randomized to using the combination shampoo (group A, 10 patients) or the 1% ketoconazole shampoo (group B, 10 patients) 3 times a week every other day for 8 weeks. Efficacy was evaluated by measuring the degree of scaling and pruritus by clinical and trichoscopic examination using a 4-point scale. Additionally, a physician global assessment (PGA) was assessed at the end of the study. Results: At 4 weeks, there was a significant reduction of scaling from baseline for both groups, while pruritus showed a significant reduction only for group A. After 8 weeks, there was a significant reduction of scaling and pruritus for both groups. PGA showed a complete response in 90% of the cases in both groups. Conclusions: The results of our study demonstrate that the combination noncorticosteroid, antiinflammatory/antifungal shampoo represents an alternative approach to standard topical treatment for scalp SD. A noncorticosteroid shampoo may be equally safe and effective as ketoconazole shampoo for scalp SD, and trichoscopy provides accurate and reliable quantifiable data to assist in therapeutic monitoring.

Use of Low-Cost Videomicroscopy versus Standard Videodermatoscopy in Trichoscopy: A Controlled, Blinded Noninferiority Trial

Affordable (USD ∼30) handheld USB digital microscopes, or videomicroscopes (VMs), that provide ×10-200 magnification are available on the web for nonmedical uses such as in botany, entomology, microelectronics or, recently, for hair/scalp evaluation. The aim of this study was to compare the reliability of low-cost VMs versus standard, medically marketed videodermatoscopes (VDs) in trichoscopy. Twenty-five patients affected by different types of hair loss were enrolled in a controlled, blinded noninferiority trial. All patients underwent examination by two low-cost VMs as well as by standard VD in order to evaluate any variability in the detection of common trichoscopic features. At the end of the study, the two low-cost VMs enabled a correct identification of all hair shaft alterations; as regards follicular and/or perifollicular examination, black dots were easily recognized by both equipments, but other follicular features, such as yellow dots, white dots and perifollicular scales, were not always adequately visualized because of low color quality and/or reduced brightness and/or resolution. In conclusion, our study suggests that the potential accuracy of low-cost VMs in the evaluation of hair loss may have some pitfalls. Therefore, a low-cost VM should not be routinely used for reliable scalp trichoscopy, unless supported by individual controlled noninferiority trials.

Oncogenic Human Papillomavirus Detection in Penile Lichen Sclerosus: An Update

Aims : Aim of this study was to better address a possible association of human papillomavirus (HPV) infection with penile lichen sclerosus (LS). Study Design: Paraffin-embedded penile biopsies obtained from adult patients with genital LS retrieved from institutional pathology files were evaluated. Place and Duration of Study: The study has been performed in the Dermatology Clinic of the University of Catania, Italy, spanning a 19-year period. Methodology: We previously demonstrated a high (17.4%) HPV detection rate in a study on 46 patients with genital LS. In this retrospective analysis we extended the analysis to a larger number of patients in order to strengthen these former data. HPV infection was assessed by polymerase chain reaction (PCR) in paraffin-embedded penile biopsies obtained from the glans or inner foreskin of 92 adult patients with penile LS and in brush cytology smears of penile healthy mucosa from an equal number of randomly selected control males matched for age. Statistical evaluation was performed using conditional logistic regression analysis. Results: PCR disclosed the presence of high risk HPV infection in 22.83% of LS patients (HPV 16:16 cases; HPV 18:1 case; HPV 31:1 case; HPV 45:2 cases; HPV 68:1 case) vs

Congenital Malalignment of the Great Toenails: A Review

Congenital malalignment of the great toenail is an underestimated dystrophic disorder of unknown origin characterized by lateral deviation of the nail plates, which are not parallel to the major axis of the distal phalanx. It usually presents in infancy or childhood, while late onset is uncommon. Treatment depends on the degree of deviation. If minimal, a conservative and expectant attitude, based on prevention and treatment of possible complications, is recommended because of the possibility of spontaneous regression of the nail deviation. Surgical therapy may be considered in patients with severe or complicated forms.

Bizarre Pigmented Lesion on the Scalp: A Quiz

A 7-year-old girl presented with a pigmented lesion on her scalp. The lesion had been present for 2 years and, according to her parents, had changed recently. Clinical examination revealed the presence on the right temporal region of a roundish, smooth, brown macule approximately 0.9×0.7 cm with unusual tiny speckles (Fig. 1A). Dermatoscopy showed a diffuse brown pigmentation and a regular network at the periphery; moreover, several yellowish globules of various shapes and dimensions were observed in the centre of the lesion (Fig. 1B). Reflectance confocal microscopy (VivaScope® 3000, Lucid, MAVIG, Munich, Germany) revealed a meshwork pattern at the dermal–epidermal junction and several roundish clusters of moderately refractive large cells with a hypo-refractive centre in the superficial dermis (Fig. 2A). The lesion was excised and histopathological examination (haematoxylin and eosin staining) revealed the features of a compound melanocytic naevus characterized by junctional nests of large cells with a pale and clear cytoplasm (Fig. 2B).

Contents Vol. 1, 2015

Editorial Board Roberto Arenas – Hospital General Dr Manuel Gea Gonzalez, Mexico City, Mexico Daniel Asz Sigall – Private Practice – Dermatology, Mexico City, Mexico Robert Baran – University of Franche-Comté, Cannes, France Wilma Bergfeld – Cleveland Clinic, Cleveland, USA Vincenzo Bettoli – University of Ferrara, Ferrara, Italy Ulrike Blume-Peytavi – Charité – University Medicine Berlin, Berlin, Germany Anna Campanati – Marche Polytechnic University, Ancona, Italy Ralph Daniel – Private Practice – Dermatology, Jackson, USA David de Berker – Bristol Royal Infirmary, Bristol, UK James Q. Del Rosso – Las Vegas Skin and Cancer Clinics, Henderson, USA Nilton Di Chiacchio – Private Practice – Dermatology, São Paulo, Brazil Zoe Diana Draelos – Dermatology Consulting Services, High Point, USA Boni Elewski – University of Alabama at Birmingham, Birmingham, USA Gabriella Fabbrocini – University of Naples Federico II, Naples, Italy Harold Farber – Center for Dermatology, Laser, and Cosmetic Surgery, Philadelphia, USA Steven Feldman – Wake Forest University, Winston-Salem, USA Stamatis Gregoriou – National and Kapodistrian University of Athens, Athens, Greece Ramon Grimalt – International University of Catalonia, Sant Cugat del Vallès, Spain Aditya K. Gupta – Mediprobe Research Inc, London, Canada Daniela Guzman-Sanchez – d & laser clinic, Guadalajara, Mexico Eckart Haneke – Private Practice – Dermatology, Freiburg, Germany Maria K. Hordinsky – University of Minnesota, Minneapolis, USA Dimitrios Ioannides – Aristotle UniversityMedical School, Thessaloniki, Greece Matilde Iorizzo – Private Practice – Dermatology, Bellinzona, Switzerland Ana Kaminsky – University of Buenos Aires, Buenos Aires, Argentina Alexandros Katoulis – National and Kapodistrian University of Athens, Athens, Greece Dong-Youn Lee – Samsung Medical Center, Seoul, Korea Bryan C. Markinson – Icahn School of Medicine at Mount Sinai, New York, USA Amy McMichael – Wake Forest University, Winston-Salem, USA Andrew G. Messenger – Royal Hallamshire Hospital, Sheffield, UK Giuseppe Micali – University of Catania, Catania, Italy Mariya Miteva – University of Miami, Miami, USA Bianca Maria Piraccini – University of Bologna, Bologna, Italy

Comuni affezioni dermatologiche

DOI: 10.1007/978-88-470-5283-3_20