Oriele Sarno

[What's new in acne? New therapeutic approaches].

Summary Well-known topical and systemic treatments for acne have advanced little over the last 10 years. However, many therapeutic approaches are being evaluated both in terms of topical and systemic treatments. The purpose of this paper is to show the progress of innovative drug projects in treating acne. The topical use of new formulations using lipid nanoparticles and microspheres could help for new products based on anti-androgens or retinoids more concentrated and better tolerated. New active agents such as topical antimicrobial peptides, inhibitors of ectopeptidase, omiganan pentahydrochloryde, antisense oligonucleotides, lauric acid are many original ways to explore for the treatment of acne. New treatment regimens for doxycycline and isotretinoin would increase tolerance. Dapsone has been evaluated for isotretinoin-resistant forms. Phototherapy narrowband light (blue or red) can find its place in the strategy for the management of acne. Finally, acne vaccines could be developped too

Efficacy of new barrier socks in the treatment of foot allergic contact dermatitis.

The prevalence of allergic shoe dermatitis in patch-tested patients for foot dermatitis is reported in the literature to be in the range 3-24.2% (1, 2). It affects both sexes and any age group, including children. The most common shoe allergens reported are potassium dichromate, p-tertiary butylphenol formaldehyde resin, rubber chemicals and dyes present in leather tanning, rubber processing and adhesives. As nickel sulphate may be present in shoe buckles and studs, this may be considered a further shoe allergen (1-8). The warm and humid environment within the shoe provides an ideal situation for the development of allergic contact dermatitis (ACD), favouring both allergen dissemination and skin absorption. The first step in treating ACD is the removal of exposure to the causative allergens, but, for social, environmental or professional reasons (e.g. safety footwear or uniform), this may be difficult in the case of foot ACD. Textile engineering has recently developed socks made of a technological fabric Microair ® barrier (Al-pretec, Venice, Italy), a three-layer fabric designed to provide a physical barrier to allergens and irritants as well as high perspirability (9). The two external layers are made of a polyester microfibre with pique construction (fabric with a raised woven design) and the internal layer is made of a microporous membrane. This membrane is reported by the manufacturer to provide the fabric with total impermeability to liquids, ions and gas, and high wicking due to very high water vapour transmission rate (1062 g/m 2 /24 h). We studied the efficiency of these devices in a selected group of patients affected by ACD to footwear allergens.

Quoi de neuf dans l'acné ? Nouvelles approches thérapeutiques

Resume Les traitements topiques et systemiques de l’acne bien connus des dermatologues ont peu evolue au cours des 10 dernieres annees. Cependant, de nombreuses pistes therapeutiques sont en cours d’evaluation aussi bien sur le plan des traitements topiques que systemiques. L’objet de cet article est de faire decouvrir l’etat d’avancement des projets therapeutiques novateurs dans le traitement de l’acne. Sur le plan topique, l’utilisation de nouvelles galeniques contenant des nanoparticules lipidiques ou des microspheres pourrait permettre d’evaluer de nouveaux produits a base d’anti-androgenes ou de retinoides plus fortement concentres et mieux toleres. De nouveaux agents actifs topiques comme les peptides anti-bacteriens, les inhibiteurs des ectopeptidases, l’omiganan pentahydrochloryde, les oligonucleotides antisens, l’acide laurique sont autant de pistes a explorer pour le traitement de l’acne. Sur le plan systemique de nouveaux schemas therapeutiques pour les doxycyclines et l’isotretinoine permettraient d’augmenter la tolerance. La dapsone dans les formes resistantes a l’isotretinoine a ete evaluee. La phototherapie a bande etroite en lumiere bleue ou rouge peut trouver sa place dans la strategie de la prise en charge de l’acne. Des vaccins sont egalement en cours d’etude.

Safe use of oral isotretinoin after pseudo-tumor cerebri due to minocycline

ejd.2011.1545 Auteur(s) : Vincenzo Bettoli1 vincenzo.bettoli@fastwebnet.it, Alessandro Borghi1, Lucia Mantovani1, Rita Scorrano2, Sara Minghetti1, Giulia Toni1, Oriele Sarno1, Stefania Zauli1, Annarosa Virgili1 1 Department of Dermatology 2 Section of Ophthalmology, Azienda Ospedaliera Universitaria di Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy A 17-year-old girl, followed for moderate acne vulgaris without endocrinological abnormalities, complained of headache, nausea, vomiting, irritability [...]

Patch testing in allergic contact dermatitis from minoxidil

A 60-year-old woman presented with itchy, eczematous, and moderately exudative lesions on the scalp after 4 months’ use of a galenic lotion of minoxidil 5% (minoxidil 5%, propylene glycol 15%, and a mixture of ethylic alcohol and water (70/30) 80%) for the treatment of androgenetic alopecia. Results of patch tests with the Italian baseline series of contact allergens (Società Italiana di Dermatologia Allergologica Professionale e Ambientale) were negative, whereas after 6 days, a repeated open application test (performed by applying the galenic minoxidil 5% lotion to the anterior surface of the arm) induced a positive reaction, which became more evident in the following 3 days. Further patch tests were carried out with the galenic minoxidil 5% preparation ‘‘as is’’ and with pure minoxidil powder at various concentrations and diluted in different solvents. The patch-test results are shown in Table 1. Due to these results, the patient was no longer a candidate for using topical minoxidil solution to treat androgenetic alopecia. Since 1984, numerous cases of allergic contact dermatitis from minoxidil solution have been reported. Excipients (mainly propylene glycol) are the agents that are more frequently responsible for allergic contact dermatitis from minoxidil solution. Although sensitization to the active principle minoxidil seems to be less common, such sensitization precludes any further treatments with preparations containing minoxidil. Thus, patients suspected of suffering from allergic contact dermatitis from minoxidil solution should be patch-tested to determine whether the causative allergen is the active ingredient itself or a solvent. It is notable that in the case reported here, contact allergy to the therapeutic formulation in use (containing propylene glycol and ethanol) and to minoxidil in alcohol was confirmed, whereas only a weak reaction to minoxidil in petrolatum was elicited. This finding was previously described as indicating a vehicle-dependent allergic contact dermatitis, presumably attributable to variation in the skin delivery of allergens in different vehicles. Propylene glycol and alcohol seem to enhance transcutaneous minoxidil penetration more than petrolatum does. In the case described, patch testing elicited a positive allergic reaction to minoxidil 5% in alcohol whereas the reaction to a 1% concentration was negative. This suggests that the concentration of minoxidil in tissue might not reach the elicitation threshold when the active ingredient is tested at From the Department of Clinical and Experimental Medicine, Section of Dermatology, University of Ferrara, Ferrara, Italy.

Pityriasis lichenoides et varioliformis acuta in pregnancy

eruption. Moreover, it has been demonstrated that nail involvement by LS could be revealed mainly during skin affection or after a trauma. Our data report a case of nail lesion, present during skin LS affection in a Caucasian woman, which is already in agreement with the data in the literature. No therapeutic agents were used after corticosteroids at the onset of the lesion, underlining that this particular LS did not respond to the same skin treatment or that treatment with drugs must be more prolonged. Moreover, the obtained results show the importance of the time needed for the nail lesions to be visible and could represent the reason why other authors did not associate nail manifestations with skin LS affection. Giovanni Maria Palleschi, MD Angelo Massimiliano D’Erme, MD Torello Lotti, MD Department of Dermatological Sciences University of Florence Florence Italy E-mail: giovannimaria.palleschi@tin.it

Upper-ear eczema: an unusual case of allergic contact dermatitis due to rubber additives

ejd.2011.1323 Auteur(s) : Monica Corazza czm@unife.it, Stefania Zauli, Oriele Sarno, Alessandro Borghi, Annarosa Virgili Clinical and Experimental Medicine, Department of Dermatology, Ferrara University, Via Savonarola 9, 44100 FerraraItaly A 50-year-old man presented with a chronic pruritic erythemato-desquamative patchy dermatitis with linear fissures involving the upper-ear region bilaterally. He had had this dermatitis for four months. On physical examination no other lesions were found [...]

Antecubital allergic contact dermatitis from intravenous iron infusion: a possible etiological role of nickel

ejd.2011.1254 Auteur(s) : Monica CORAZZA1, Alessandro BORGHI1, Oriele SARNO1, Chiara MARANINI1 czm@unife.it, Antonella PAGNONI2, Daniela PALMERI3, Annarosa VIRGILI1 1 Department of Clinical and Experimental Medicine, Section of Dermatology, University of Ferrara, Via Savonarola 9, 44100 Ferrara, Italy 2 Department of Chemistry, University of Ferrara, Ferrara, Italy 3 Electron Microscopy Center, University of Ferrara, Ferrara, Italy A 37-year-old woman receiving treatment with daily intravenous infusions [...]