P. Biggio

Glycolic acid peeling in the treatment of acne

Glycolic acid chemical peels have been widely accepted as a useful modality in many cutaneous conditions characterized by abnormalities of keratinization.

Tinea capitis in children in the district of Cagliari, Italy

Summary. Between 1986 and 1995, 4104 children were observed in the Clinic of Dermatology in Cagliari, Italy. Three hundred and thirty‐six children (8.2%), 188 boys and 148 girls, aged 1 month to 13 years, were affected by tinea capitis. Microsporum canis was detected in 278 cases (82.7%) and Trichophyton mentagrophytes in 58 cases (17.3%). Systemic treatment with 20–25 mg kg‐1 day‐1 griseofulvin led to complete recovery in 30–40 days. None of the patients relapsed. The epidemiology of the infection was analysed according to age, sex and seasonal progression. Microsporum canis was the preponderant aetiological agent of tinea capitis in children in the district of Cagliari, Italy.

Clinical efficacy and tolerability of terbinafine in patients with pityriasis versicolor

Summary. The antifungal efficacy and tolerability of 1% terbinafine cream vs. 1% bifonazole cream were assessed in a single blind randomized trial in patients with pityriasis versicolor. Terbinafine, a drug of the allylamines group, a new class of antimycotic agents, blocks sterol biosynthesis in the pathogen through inhibition of squalene epoxidase and consequent squalene accumulation, a primarily fungicidal process. Forty pityriasis versicolor patients, (18 M, 22 F; mean age 32.4 years; min. 16, max. 65), used 1% terbinafine cream or 1% bifonazole cream for a maximum of 4 weeks. All patients were followed‐up weekly both clinically and my‐cologically. Clinical cures, defined as negativization of each clinical parameter, were recorded for 20 terbinafine patients (100%) and 19 bifonazole patients (95%), with routine microscopy and Woods light tests both negative. By the 2nd week of treatment, 2 terbinafine patients were mycologically cured (10%). By the 3rd week, 14 terbinafine patients (70%) and 5 bifonazole patients (25%) were mycologically cured. The present controlled clinical trial consequently demonstrates that terbinafine is rapidly effective and well tolerated for treatment of pityriasis versicolor.

Tinea pedis observed in Cagliari, Italy, between 1996 and 2000.

Summary The aim of this study was to verify the incidence of tinea pedis in patients observed in the Department of Dermatology of the University of Cagliari, Italy, in the period from 1996 to 2000. We examined 722 patients, 536 with lesions and 186 without lesions of the feet and in 169 of them (23.4%) we diagnosed tinea pedis. All patients suffering from tinea pedis belonged to the group with lesions. In the 536 patients with clinical manifestations which were evident to a certain degree, microscope and cultural examination gave positive results for dermatophytes in 169 cases (31.5%). The most frequently isolated dermatophyte was Trichophyton mentagrophytes (51.5%), followed by Trichophyton rubrum (45.2%) and Epidermophyton floccosum (3.3%). In the 186 patients without lesions, direct microscope examination was consistently negative while cultural examination showed the growth of sparse colonies of Candida albicans in two cases (1.1%) We analysed distribution by sex, age, residence, occupation and clinical manifestations. Stressing the high frequency of tinea pedis in this region, the discovery of a dermatophytic infection of the feet with an absence of signs and symptoms is an exceptional event.

Pityriasis rotunda: A Survey of 42 Cases Observed in Sardinia, Italy

BACKGROUND Pityriasis rotunda (PR) is an uncommon dermatosis characterized by multiple, round or oval, sharply demarcated scaling patches that are dyschromic and asymptomatic. It has been described in Japanese and in blacks, usually in association with certain infective or malignant systemic diseases. OBJECTIVE The aim of this study is to further clarify this rare entity which in Italy seems to be confined to the island of Sardinia. METHODS We studied 42 Sardinian patients, 22 males and 20 females, in an age range of 3-32 years. In 29 cases, the disease involved more than one family member. The patients were observed in Cagliari, the capital city of Sardinia. RESULTS Bacterial, viral and fungal investigation yielded negative results. Haematochemical and immunological examination and thyroid, hypophyseal and adrenal hormones did not reveal any alterations. No systemic pathologies were found associated with the disease. CONCLUSIONS The cases studied by us and those previously reported seem to indicate the presence of two distinct types of PR with significant prognostic differences.

Kerion Celsi: a clinical epidemiological study

Summary. We present a case record of patients with kerion Celsi observed in the Clinic of Dermatology, University of Cagliari (Italy) from 1981 to 1995. Altogether, 31 children (18 male and 13 female) with an age range of 40 days to 12 years were studied. In all cases the lesions were confined to the scalp. In 10 cases the disease developed as such, while in 21 patients it represented the inflammatory evolution of tinea capitis secondary to incongruous topical treatment. Microsporum canis was isolated in 22 cases and Trichophyton mentagrophytes in nine cases. Systemic treatment was carried out in 20 patients with griseofulvin, in six with ketcconazole and in five with terbinafine. Complete recovery was obtained in 25–30 days. No cases of relapse were observed. The authors stress the importance of an early diagnosis followed by timely and effective treatment to prevent scarring and permanent hair loss.

Lichen planus in a child requiring circumcision.

Abstract: Lichen planus is a rare disorder in infants and children where it usually has the classical cutaneous pattern and only exceptionally involves the mucosa and skin appendages. A 9‐year‐old boy was referred to our department with a 4‐month history of erythematous keratotic papules on the trunk and the upper and lower limbs. There were no signs of mucosal involvement. Subsequently white papules and striae, occasionally forming a lace like pattern, appeared on the penis and prepuce which quickly led to phimosis necessitating circumcision. Histologic examination of skin biopsy specimens and genital mucosa fragments confirmed the clinical diagnosis of lichen planus.

Kerion Celsi in a newborn due to Microsporum canis

The present study deals with a case of a 40‐day‐old girl with kerion Celsi caused by Microsporum canis. The source of the infection were the parents who presented tinea corporis caused by M. canis. Systemic treatment was carried out with terbinafine and complete recovery was achieved. Tinea capitis is unusual in children during their first year of life and its evolution towards kerion is very rare in newborns.

Drug‐induced sweat gland necrosis in a non‐comatose patient: a case presentation

Background Coma‐induced bullae and sweat gland necrosis is a rare clinicopathological entity often associated with drug‐induced coma.

Case Report. Pityriasis versicolor mimicking Pityriasis rotunda

Summary. Pityriasis versicolor is a common dermatomycosis, occurring throughout the world, characterized by irregular, slightly scaly patches, varying in color from red/light brown to white. Pityriasis rotunda, on the other hand, is an uncommon disease, reported in specific ethnic groups, and characterized by perfectly round or oval patches of varying color, with a scaly surface. The histologic pattern is that of ichthyosis vulgaris. We report here the case of a male patient, aged 31, from Sardinia (Italy), affected by Pityriasis versicolor mimicking Pityriasis rotunda. Mycological examination allowed us to formulate the correct diagnosis, and ensuing treatment with antifungal drugs was entirely successful. The authors, while pointing out the rarity of this case, stress the possibility that Pityriasis versicolor mimics Pityriasis rotunda and vice‐versa, especially in those countries in which the two diseases are endemic. More widespread recourse to microscopic examination can help avoid the risk of mistaken diagnosis and consequent incorrect treatment.