Maria Michela Lauriola

Use of topical herbal remedies and cosmetics: a questionnaire-based investigation in dermatology out-patients.

Background Although topical remedies and cosmetics based on herbal ingredients are becoming increasingly popular with the public due to the perception that botanical compounds are safer and healthier than their synthetic counterparts, a large number of adverse cutaneous effects of plant extracts, notably contact sensitization, have been reported in medical literature.

Surfactants, skin cleansing protagonists

The correct choice of cosmetic products and cleansers is very important to improve skin hydration, to provide moisturizing benefits and to minimize cutaneous damage caused by surfactants. In fact, surfactants may damage protein structures and solubilize lipids. Soaps, defined as the alkali salts of fatty acids, are the oldest surfactants and are quite aggressive. Syndets (synthetic detergents) vary in composition and surfactant types (anionic, cationic, amphotheric, non‐ionic). These new skin cleansing products also contain preservatives, fragrances, and sometimes emollients, humectants and skin nutrients. We present a revision of the literature and discuss recent findings regarding skin cleansers.

Vulvar lichen sclerosus: 11 women treated with tacrolimus 0.1% ointment.

Lichen sclerosus is a chronic relapsing disease, usually treated with ultra-potent corticosteroids. As immunological alterations are considered important aetiopathogenetic factors in lichen sclerosus, the new immunomodulating topical agents, such as tacrolimus and pimecrolimus, have been employed sporadically as alternative therapies. The aim of this study was to evaluate the therapeutic effects of tacrolimus 0.1% ointment in lichen sclerosus in 11 patients unresponsive or poorly responsive to previous treatments. Tacrolimus 0.1% ointment was applied twice daily for 6 weeks, then tapered over a further 6 weeks. Symptoms and objective parameters were evaluated and quantified at the start, after 6 weeks, at the end of the topical treatment, and at follow-up visits. Improvement or remission of symptoms was observed in the patients who completed the study, while objective parameters were poorly influenced and often were not related to symptom behaviour. Topical tacrolimus can be considered an alternative treatment for lichen sclerosus.

Topical botanically derived products: use, skin reactions, and usefulness of patch tests. A multicentre Italian study

The evidence on the safety of topical preparations containing botanical extracts is limited.

Sweet's Syndrome: A Retrospective Clinical, Histopathological and Immunohistochemical Analysis of 11 Cases

The aim of this paper is to report our clinical experience of Sweets syndrome, a severe dermatological disease which may be extremely important to recognize for the early diagnosis of a neoplastic disorder. Eleven patients affected by Sweets syndrome, treated at the Department of Dermatology, University of Ferrara, Ferrara, Italy, during 1998 to 2004, were evaluated. A retrospective analysis was performed. Data on age, sex distribution, clinical data, histopathological and immunohistochemical findings and therapy were collected. We observed one patient with idiopathic form, 5 patients affected by the para-inflammatory variant and 5 para-neoplastic cases (with haemoproliferative diseases). The cases with the para-inflammatory form were affected by minor infectious manifestations. Prolonged follow-up is necessary to verify that a case of idiopathic variant is not really a paraneoplastic form. Based on immunohistochemical analysis, we cannot exclude that true histiocytes, immunoreactive for CD68/PGM, infiltrate the dermis in Sweets syndrome lesions.

Tacrolimus 0.1% Ointment: Is It Really Effective in Plasma Cell Vulvitis?

Background: Plasma cell vulvitis is a clinically and histologically well-characterized chronic disease that usually relapses after various topical therapies. Considering the inflammatory nature of the disease, the new topical calcineurin inhibitors have been also employed successfully in few cases of Zoon’s balanitis, the corresponding male condition. Objective: The aim of our study is to evaluate the effectiveness of tacrolimus ointment in a small group of plasma cell vulvitis sufferers. Methods: 4 women affected by biopsy-proved plasma cell vulvitis were enrolled, after informed consent. The topical drug was applied twice daily for 6 weeks, then tapered on the basis of the clinical results. Symptoms and objective parameters were obtained periodically at the beginning, after 6 weeks and up to the end of the topical treatment. A final biopsy was performed in 3 out of our 4 patients. The follow-up is still ongoing. Results: The comparative analysis of subjective, objective and histopathological data has shown discordant and less encouraging results than those reported for the corresponding male condition. Conclusion: At the moment, topical tacrolimus could be considered an alternative treatment for plasma cell vulvitis only in cases resistant to conventional therapies.

Allergic Contact Dermatitis due to Cinnamon Oil in Galenic Vaginal Suppositories

© 2010 The Authors. doi: 10.2340/00015555-0782 Journal Compilation

Allergic contact dermatitis caused by argan oil, neem oil, and Mimosa tenuiflora

Conflicts of interest: The authors declare no potential conflict of interests. Funding: None. Both authors participated in the writing of this manuscript. therapies, traditional Chinese medicine, homeopathy, and dietary supplements, to be remedies with a perceived lack of side-effects (1). Several herbal preparations (i.e. Aloe vera, Indigo naturalis, Mahonia, Camptotheca, Mimosa tenuiflora, Argania spinosa kernel oil, and Melia azadirachta seed oil) have been claimed to be beneficial for treating psoriasis, although the level of scientific evidence is low (1). However, natural remedies may be non-negligible causes of allergic contact dermatitis (2).

An unusual local reaction after microsclerotherapy with chromated glycerin.

A case of papular itching lesions after microsclerotherapy with chromated glycerin (CG) at a 72% concentration for telangiectases of the thighs is reported. Patch-test results were strongly positive for nickel sulfate (+++/+++) and thimerosal (++/++) whereas results were negative for the sclerosing agent CG 72% and glycerol (control). Intradermal injection of CG 72% in the thigh and intravascular injection of CG 72% into telangiectases of the knee produced erythematous papular itching lesions in about 5 to 6 hours. As a negative control, glycerol and sodium chloride 0.9% injected intradermically on the thigh did not cause any reaction. CG can elicit allergic reactions in patients who are sensitive to chromium and can cause new sensitizations to chromium. In our case, no positivity to potassium dichromate was observed.

Contact Vulvitis due to Pseudowintera Colorata in a Topical Herbal Medicament

Sir, Besides traditional topical and systemic pharmacological treatments for the therapy of vulvovaginal yeast and bacterial infections, numerous over-the-counter medicaments containing natural substances (e.g. tea tree oil, echinacea, sodium caprylate, propolis) are marketed. Patients often prefer alternative medicine and selfprescribe herbal-based products. We report here an unusual case of acute vulvitis that occurred in a young patient after prolonged topical use of an antifungal herbal preparation.