M. Mastrolonardo

Classical Kaposi’s Sarcoma: A Survey of 163 Cases Observed in Bari, South Italy

BACKGROUND Classical Kaposis sarcoma (KS) is a sporadic disease that is particularly prevalent in Mediterranean countries. OBJECTIVE The aim of the study was to update clinical information about this rare condition. METHODS A survey of 163 cases observed in the period 1971-1990 in Bari, South Italy, was carried out. All records were reviewed and, when lost to follow-up for more than 6 months, patients were called back to update personal and family histories. The age at onset averaged 64 years (range 18-85). The male-to-female ratio was 3:1. No familiar occurrence was identified, and no significant association was found with other conditions (i.e. second primary malignancies and diabetes mellitus). Death from KS occurred in 16 cases, at the mean age of 71 years, an average of 5.7 years after the onset of the disease. To assess whether the different clinical patterns of the disease in its earlier stages may give any indication of its subsequent clinical course, all cases were re-classified into three groups (low-, moderate- and high-eruptivity group) on the basis of both the extent and the rate of spread of the disease before first admission; group-stratified survival function was evaluated using Kaplan-Meiers life table method. RESULTS Highly significant (p < 0.0001) differences were found in survival profiles of the three study groups, also when only deaths due to KS were computed. CONCLUSION These findings provide some support to the hypothesis that three subsets of classical KS exist that have different prognoses and, consequently, need different therapeutic approaches.

Cutaneous sporotrichosis in the period 1978–1992 in the province of Bari, Apulia, Southern Italy

Summary. The authors report 16 cases of cutaneous sporotrichosis observed in the province of Bari, southern Italy, since 1978. While no more than 55 cases have been documented in other European countries in the last 30 years, in Italy 58 cases (present series included) have been recorded in the same time period. Furthermore, 42 of them (73.7%) originated from Apulia. This unexpectedly high incidence rate in Italy, and in Apulia in particular, provides evidence of the important role played by this area in the eco‐epidemiology of sporotrichosis in Europe.

Peeling agents: toxicological and allergological aspects

The use of peeling agents is very common in clinical practice. However, despite the overall good safety profile, it is not without any inherent risk; therefore, clinicians should be adequately informed about potential risk in order to avoid or prevent them.

Topical finasteride in the treatment of androgenic alopecia. Preliminary evaluations after a 16-month therapy course

The enzyme 5α-reductase (5AR), which catalyzes reduction of testosterone to the more potent metabolite dihydrotestosterone, has been assumed to play a key role in a variety of skin disorders, including acne, seborrhea, hirsutism, and androgenic alopecia (AA). Also, evidences have been provided supporting the pathogenetic relevance of higher rates of testosterone reduction at lesional level. The azasteroid finasteride, a 5AR inhibitor, is widely employed in the treatment of benign prostatic hyperplasia; by contrast, its potential role in other androgen-related conditions have been, so far, only poorly evaluated.We present herein the results of a single-blind, placebo-controlled, 16-month trial carried out in 52 patients with AA using a 0.005% finasteride solution. The clinical outcome, in terms of both hair regrowth and balding areas reduction, seems to be encouraging, in the absence of either any evidence of percutaneous absorption of finasteride, or local/systemic untoward effects.We also briefly review ...

Oral retinoids in the treatment of pityriasis lichenoides

The aetiopathogenesis of pityriasis lichenoides (PL) is still far from clearly understood. However, the involvement of delayed-type immune dysfunctions has recently been hypothesized. On the basis of this premise, and in view of the recognized immunomodulating effects of synthetic derivatives of vitamin A, an open trial was carried out of the efficacy and tolerability of oral etretinate in four men, aged 21 to 49 years, with PL. With a daily dosage of 1 mg/kg, full resolution was achieved in 6-18 weeks. The overall tolerability was good, with mild to moderate mucocutaneous side-effects. The relapse-free period had currently reached 8-12 months. Oral etretinate seems to be a promising therapeutic tool in the management of PL, for which to date no definitive treatment exists.

Topical 5-fluorouracil in the treatment of discoid lupus erythematosus. Preliminary study over two years

To our knowledge, no trial has so far been performed of 5-fluorouracil (5-FU) in the treatment of discoid lupus erythematosus. This open label study was carried out in 12 patients (5 males and 7 females, aged 20 to 47 years) to assess the short-and long-term efficacy and tolerability of a daily application of an ointment containing 5% 5-FU. The study was started in October 1993 when the disease was at a high degree of activity following summer sunlight exposure. After a 4-to 24-week treatment period, full remission was achieved in all patients. Healing resulted in cosmetically acceptable dyschromic and/or atrophic changes. During the summers 1994 and 1995, exacerbation of preexisting lesions and appearance of new lesions were observed in eight and two patients, respectively. However, remission of these lesions was obtained with a short course of therapy. The overall tolerability of the treatment was good or excellent in all patients. On the basis of the results of this preliminary study, topical 5-FU seem...

Aggressive Kaposi's sarcoma associated with adenocarcinoma of the sigmoid in a woman without evidence of acquired immune deficiency syndrome

We describe the case of a 50‐year‐old Caucasian woman with Kaposis sarcoma. After nearly 15 years of very benign course, a sudden exacerbation of the disease led to extensive involvement of the lower limbs and amputation of distal phalanxes of toes on the left foot. Of note, a previously overlooked adenocarcinoma of the sigmoid and oesophageal candidiasis were also detected in the absence of any obvious cause of immunosuppression.

Kaposi's varicelliform eruption in a patient with pemphigus foliaceus under steroid therapy

The association between pemphigus and herpesvirus infection is only rarely observed. We report a Kaposis varicelliform eruption developed in a woman with pemphigus foliaceus under steroid therapy.