Ilaria Ghersetich

Cutaneous small-vessel vasculitis

Cutaneous small-vessel vasculitis (CSVV) refers to a group of disorders usually characterized by palpable purpura; it is caused by leukocytoclastic vasculitis of postcapillary venules. CSVV can be idiopathic or can be associated with a drug, infection, or underlying systemic disease. Initially, the pathogenesis of CSVV is immune complex related, but in its later stages different pathogenetic mechanisms may intensify the reaction and lymphocytes may predominate in the infiltrate. Cure requires elimination of the cause (ie, drugs, chemicals, infections, food allergens) when possible, as well as therapy with nonsteroidal antiinflammatory agents, corticosteroids, dapsone, potassium iodide, fibrinolytic agents, aminocaproic acid, immunosuppressive agents (ie, cyclophosphamide, azathioprine, methotrexate, cyclosporine) or even monoclonal antibodies, depending on disease severity.

Proteoglycans in so-called cellulite.

ABSTRACT: Glycosaminoglycans are a group of polysaccharide chains covalently linked to proteins to form proteoglycan molecules with high water‐attracting properties. The ultra‐structural localization of glycosaminoglycans in the so‐called cellulite skin and in normal subjects was studied. Data show that there is increasing concentration of glycosaminoglycans in the cellulite skin, presumably leading to a rise in the amount of water retained in the skin in this disease.

The neuro-immuno-cutaneous-endocrine network: relationship between mind and skin.

ABSTRACT:   Brain‐body(skin) influences are bi‐directional and skin should be considered as an active neuro‐immuno‐endocrine interface, where effector molecules act as common words used in a dynamic dialogue between brain, immune‐system and skin. It has been widely demonstrated that stimuli received in the skin can influence the immune, endocrine and nervous systems at both a local and central level. However, the brain can also modulate inflammatory conditions locally induced in the skin. It has been experimentally demonstrated that intracerebral administration of the tridecapeptide α‐MSH or even its COOH‐terminal tripeptide can in fact inhibit cutaneous inflammation induced by the application of topical irritants and intradermal injection of cytokines. The skin can therefore alter the pharmacology of the CNS by releasing large amounts of NPs which obviously do work locally in the skin and beyond the skin. α‐MSH may represent a key molecule for understanding this aspect of cutaneous‐immune‐neuro‐endocrine‐mental biological communication, being it is also generated in the skin. This molecule may in the future be used as a potent anti‐inflammatory agent in clinical dermatology, and preclinical trials are presently in progress.

ALOPECIA AREATA: IMMUNOHISTOCHEMISTRY AND ULTRASTRUCTURE OF INFILTRATE AND IDENTIFICATION OF ADHESION MOLECULE RECEPTORS

Background. Alopecia areata (AA) is a noncicatricial alopecia with still unknown pathogenesis, but increasing evidence suggests that an immunologic process might be responsible for the disease.

Nd:YAG 1064 nm laser in the treatment of facial and leg telangiectasias

Background Facial and leg telangiectasias are a frequent cosmetic concern for both females and males with various skin types and ages. To date the different treatments for these problems, in particular leg telangiectasias, have frequently failed or led to negative side‐effects.

The use of pyruvic acid in the treatment of acne.

Background  Acne is one of the most common dermatological diseases, affecting about 50% of adolescents. Different chemical peelings are used in local treatment, either alone or in association with other therapies.

Immune response to Leishmania infection in human skin

Leishmania is a serious infectious disease found on all the continents except Australia and Antarctica.1 There are several species of the genus Leishmania. Each species tends to occupy a particular zoo-geographical zone. Species are morphologically identical and are distinguished by their iso-enzyme patterns and DNA analysis. Monoclonal antibodies have also proved useful for rapid identification of isolates, especially in the field.2 Cutaneous leishmaniasis in the Old World is due to L. donovani, L. major, L. tropica, L. aethiopica, and L. infantum; the latter is responsible for the disease in the Mediterranean basin, for some cases in North Africa and Asia. Cutaneous leishmaniasis in the New World is mainly due to L. mexicana, L. brasiliensis, and L. peruviana. American leishmaniasis is an endemic and mainly rural disease of damp, forested areas in South and Central America.3 It becomes epidemic among young men who work in the forest, 25% of young soldiers fighting in the jungle in certain areas, and in villagers settled on land recently taken from the tropical forest. The optimum time for transmission is immediately after the rainy season.

Immunologic aspects: immunology of mineral water spas.

Mineral waters are natural solutions formed under specific geological conditons and characterized by a “chemico-physical dynamism.” Attempts to prepare artificial mineral waters have failed because of the different biological activities related to this chemico-physical dynamism.’ Mineral water has three fundamental characteristics:’ spring origin, bacteriologically pure, and therapeutic potential.

Chemical peeling: How, when, why?

Abstract General description Chemical peeling is a procedure frequently used to treat unaesthetic cutaneous alterations such as photoageing, actinic keratosis, chloasma, senile lentigo, and post-acneic scars as well those of a non-strictly aesthetic nature such as seborrhoeic keratosis and flat warts. Several chemical agents are used depending on the depth of peeling to be obtained. The most commonly used agents are: alpha-hydroxy-acids, resorcinol, Jessners solution, and trichloroacetic acid. In the present study the characteristics of the individual substances, technical procedure, and applications are taken into consideration. Finally, the main risks and side-effects, depending on the depth of peeling, are considered. Learning objective The reader will have learned what a chemical peeling is, what chemical agents are available, and how to perform chemical peeling in the office. The mechanism of action of different chemical agents, expectations from this procedure, potential risks and complications are also reviewed with insight into criteria for selecting patients.

Alpha-lnterferon Cream Restores Decreased Levels of Langerhans/indeterminate (CD1a+) Cells in Aged and PUVA-Treated Skin

Langerhans/indeterminate (CD1a+) cells are known for their role in stimulating T-lymphocyte-dependent immune reactions. They are normally present in the skin and are modified in a variety of different pathological and physiological events, including aging. Linear decrease of CD1a+ cells with aging (both true aging and photoaging) is considered the most important cause of reduced immunosurveillance in aged old skin of the elderly. Recently it has been suggested that alpha-interferon might have an effect on increasing levels of dendritic cells in aged and photoaged skin. We studied biopsies from the preauricular area in 15 subjects (5 subjects aged 18-21 years, 5 aged 57-75, and 5 aged 30-45 who underwent PUVA therapy, total irradiation 120 J/cm2) before and after the application of alpha-interferon cream. Our findings show that dendritic cells are significantly decreased in the 57- to 75-year-old group compared to the 8- to 21-year-old group. After PUVA therapy we also found a decrease in Langerhans cells. Our study shows that the application of alpha-interferon cream induces an increase in cutaneous CD1a+ cells and HLA-DR+ cells in both older subjects and subjects who have undergone PUVA therapy. On the basis of these results, one could hypothesize that alpha-interferon cream may have some beneficial effects on photoaging-reduced immunosurveillance.