Maria Rita Bongiorno

Exogenous ochronosis and striae atrophicae following the use of bleaching creams

Exogenous ochronosis is a paradoxical hyper‐pigmentation of the skin caused by the long‐term use of hydroquinone‐containing bleaching creams. Ochronosis is an uncommon condition characterized by yellow‐brown pigmented deposits in the dermis. We report two cases of exogenous ochronosis in two female patients of the sub‐Saharan African population. The lesions were characterized by an asymptomatic hyper‐pigmentation of the face with gradually progressive blue‐black macular patches, and in case no. 2, in addition to dyschromic lesions, striae atrophicae were present. This phenomenon is the outcome of the use of skin care products containing high concentrations of hydroquinone‐ and glucocorticoid‐based products, and, in addition, certain modalities in the use of bleaching products are likely to facilitate complications.

Novel Terphenyls and 3,5-Diaryl Isoxazole Derivatives Endowed with Growth Supporting and Antiapoptotic Properties

A new study on terphenyl and diaryl-isoxazole and -isoxazoline derivatives, maintaining a common 3-adamantyl-4-hydroxyphenyl moiety, has been conducted to find compounds with growth supporting and antiapoptotic properties. Unexpectedly, diphenyisoxazole derivatives bearing a nitro group replacing the carboxylic function have been found with the highest cell protective activity within the series, in complete and in serum-free conditions. Inhibition of apoptosis induced by daunorubicin has also been observed for the most active compound.

Multiple nevoid spiradenomas.

This report delineates a new clinical presentation of multiple benign spiradenoma (BS), a diffuse linear nevoid pattern. A 16-year-old girl, in otherwise good health, had many papulonodular lesions, varying in color from blue-gray to bright red, disposed linearly on the right half of her body, involving the periorbital region, cheek, lateral side of the neck, trunk, linea alba, right thigh, and leg. Only a few nodules were slightly painful. Lesions were reported to be present at birth; no family members had similar lesions, either in solitary or multiple form. Excisional biopsies of three lesions from the neck, abdomen, and leg, respectively, were performed; histologically, all three samples showed a picture of BS. In some areas, the tumor was directly connected to a pilosebaceous unit. Furthermore, a focal area with pilar differentiation at the periphery of the lobules was observed, which might suggest that BS can differentiate toward various cutaneous adnexal structures. Our patient probably is the first one reported with diffuse linear nevoid lesions of BS, present at birth and involving the right half of the body.

Efficacy, safety and quality of life of calcipotriol/betamethasone dipropionate (Dovobet) versus calcipotriol (Daivonex) in the treatment of psoriasis vulgaris: a randomized, multicentre, clinical trial

Objective: A clinical trial was performed to evaluate the efficacy, speed of response, side effects and quality of life of patients treated with calcipotriol/betamethasone dipropionate (Dovobet®) for 4 weeks followed by maintenance with calcipotriol for 8 weeks (group A) versus calcipotriol (Daivonex®) alone for 12 weeks (group B) for the treatment of psoriasis. Materials and methods: A total of 150 patients were enrolled and randomized to groups A and B. PASI and Skindex‐29 were considered the outcome measures. Results: Ninety‐six patients completed the trial. At weeks 2 and 4, both groups showed a significant clinical improvement compared to baseline; group A demonstrated a higher clinical response compared with group B (p<0.001). Treatment with calcipotriol was associated with a gradual improvement in group B and maintenance of the results in group A. Similarly, the quality of life assessment showed a marked improvement in terms of Skindex‐29 in both groups at weeks 2 and 4 compared to baseline. Both treatments were safe and well tolerated. Conclusions: Our results demonstrate a higher efficacy and more rapid onset of action with the two‐compound ointment compared with calcipotriol cream alone in short‐term treatment. However, sequential application of calcipotriol allows maintenance of the results.

Rituximab in refractory pemphigus vulgaris

ABSTRACT:  Pemphigus vulgaris (PV) is a severe chronic autoimmune blistering disease of skin and mucous membranes. The use of systemic corticosteroids in pemphigus has dramatically reduced its mortality rate, but the long‐term use of steroids leads to severe side effects, many of which are serious. For this reason it is often necessary to add immunosuppressive agents to the regimen. However, there are occasional refractory cases in which therapy with conventionally accepted modalities is either not efficacious or not possible on account of side effects. Rituximab is a therapeutic monoclonal antibody targeting CD20, an integral membrane protein highly expressed on the surface of pre‐B lymphocytes and activated mature B lymphocytes. We present an instance of refractory PV successfully treated with rituximab. The successful treatment of pemphigus described here demonstrates that rituximab is a viable therapeutic option for patients with refractory PV.

The prevalence of the obesity in patients with moderate to severe psoriasis in Sicily populations

the role in AD pathogenesis. In conclusion, presented data suggest that the SNP at position – 1154 of the promoter region of the VEGF gene may play a role in pathogenesis of AD, but the functional effect of these polymorphisms is not clear. In our opinion, further investigations towards other functional SNPs of the VEGF gene and VEGF expression in larger group and different populations are required.

Primary malignant melanoma of the oral cavity: case report

An 80‐year‐old‐female patient had a pigmented lesion on: the hard palate, the soft palate, the alveolar mucosa and the vestibolar mucosa of the maxillary gingiva. Pigmented macules and patchs had been persistent and asymptomatic for many years ( Fig. 1 ). The lesion exhibited irregularities of pigmentation, border and surface contour. About 1 year later the patient had noticed an extension of the pigmented macules and plaques; there was also the appearance of nodules of the maxillary gingiva accompanied by swelling. Loosening of teeth as a result of extensive destruction of bone was further noted ( Fig. 2 ).

A novel mutation of the extracellular matrix protein 1 gene (ECM1) in a patient with lipoid proteinosis (Urbach-Wiethe disease) from Sicily.

Background  Lipoid proteinosis (LP), also known as Urbach–Wiethe disease, is a rare autosomal recessive disorder characterized by a hoarse voice, warty skin infiltration and scarring. Mutations within the extracellular matrix protein 1 (ECM1) gene cause LP.

Unusual clinical variants of cutaneous leishmaniasis in Sicily

Background  The term “leishmaniasis” defines a group of vector‐borne diseases caused by species of the genus Leishmania and characterized by a spectrum of clinical manifestations. Parasite properties (infectivity, pathogenicity, virulence), host factors, and host responses regulate heterogeneous disease expression. Sicily is one of the major islands of the Mediterranean Basin and is considered to be a hypo‐endemic area for cutaneous leishmaniasis. Leishmania infantum is the most common species on the island.

Achilles tendon ultrasonography may detect early features of psoriatic arthropathy in patients with cutaneous psoriasis.

Psoriatic arthropathy is a progressive and debilitating disease involving reduction of functional activity of the articulations with consequent deterioration of the patients quality of life. The entheses represent the initial site of articular inflammation and the enthesis of the Achilles tendon is the first to be affected. In some patients with psoriasis, enthesitis may not be diagnosed because it is still asymptomatic.