Pasquale Patrone

A retrospective epidemiological study on the association of bullous pemphigoid and neurological diseases

Bullous pemphigoid is a rare chronic recurrent dermatosis that is often reported in association with various neurological diseases. No investigation involving a large number of patients has ever been carried out to demonstrate such an association. This study was accomplished by analysing the discharge diagnosis of all hospitalized patients, both day-patients and inpatients, during a 5-year period (1995-2000) covering a total population group of 934,023 living in a region of Italy that has approximately 1,200,000 inhabitants. The results support the hypothesis of an association between bullous pemphigoid, multiple sclerosis and Parkinsons disease on a highly significant statistical basis. The aetiopathogenic mechanisms and the causes that induce the loss of immunological tolerance are not yet understood.

Multiple cutaneous neoplasms in a patient with Rothmund-Thomson syndrome : Case report and published work review

Rothmund–Thomson syndrome (RTS) is a rare genodermatosis characterized by early poikilodermatous skin lesions, often combined with juvenile cataracts, photosensitivity and bone defects. Data in the published work indicate that there is an increased risk of RTS patients developing malignant tumors. Herein, we report the multiple skin carcinomas observed in a case of RTS and review the published work on the occurrence of malignant tumors in these patients. We report the case of a 63‐year‐old male with RTS who developed multiple cutaneous neoplasms (three basal cell carcinomas, three squamous cell carcinomas and Bowens disease) over the previous 15 years. A published work review confirmed that RTS is a genetic condition that predisposes subjects to the development of bone tumors, especially at an early age, and skin tumors at an adult age. Therefore, alongside careful osteoarticular monitoring to identify a bone tumor quickly, during the life of a patient suffering from the syndrome, it is just as important to take appropriate preventive action and monitor the possible onset of skin tumors.

Relationship between sebostatic activity, tolerability and efficacy of three topical drugs to treat mild to moderate acne.

Background  Acne is a multifactorial disorder in which the sebum plays an important pathogenetic role.

Hypertriglyceridaemia during treatment with adalimumab in psoriatic arthritis

associated with rituximab therapy. Br J Haematol 2003; 121:913–18. 12 Micallef IN, Kahl BS, Maurer MJ et al. A pilot study of epratuzumab and rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy in patients with previously untreated, diffuse large B-cell lymphoma. Cancer 2006; 107:2826–32. 13 Voog E, Morschhauser F, Solal-Celigny P. Neutropenia in patients treated with rituximab. N Engl J Med 2003; 348:2691–4. 14 Terrier B, Ittah M, Tourneur L et al. Late-onset neutropenia following rituximab results from a hematopoietic lineage competition due to an excessive BAFF-induced B-cell recovery. Haematologica 2007; 92(Suppl. 3):ECR10.

Cutaneous Vascular Alterations in Psoriatic Patients Treated with Cyclosporine

Videocapillaroscopy can be used to assess cutaneous microcirculation modifications in vivo, and therefore allows assessment of variations in the microvascular architecture in psoriatic subjects during treatment. The aim of this study was to observe and quantify the modifications of the superficial capillary bed in psoriatic plaques during treatment with cyclosporin A. Twelve patients with psoriasis vulgaris were treated with an initial dose of 4 mg/kg/day cyclosporin A over a period of 3 months with periodic clinical and capillaroscopic assessments. Clinical resolution of the lesions and a reduction in microcirculatory alterations was observed in 70% of patients, although none returned to a normal capillaroscopic pattern.

Immunohistochemical study before and after narrow band (311 nm) UVB treatment in vitiligo

The present study was aimed at evaluating correlations between clinical response and the histochemical and immunohistochemical changes in vitiligo patches treated with narrow-band UVB phototherapy. Eighteen patients, 13 females and 5 males, aged between 15 and 67 years, affected by vitiligo were recruited and 14 patients completed the study. Before starting the narrow-band UVB treatment three biopsies were carried out on the lesional, perilesional and healthy skin of each patient, excluding the face. After 9 months treatment an additional biopsy was performed on repigmented skin areas adjacent to the lesional biopsy site. For the histochemical evaluation, the Masson-Fontana argentaffin reaction was carried out; for the immunohistochemical study, two antigens were studied: tyrosinase and HMB 45. Clinical improvement was assessed by evaluating the repigmented surfaces, expressed in percentages of the respective vitiligo areas. The results obtained confirm the effectiveness and safety of narrow-band UVB phototherapy for vitiligo, in terms of both good clinical-histological results and absence of important side effects. In addition to attesting the efficacy of narrow-band UVB phototherapy, immunohistochemical tests also appeared to have a potential interest for prognostic purposes.

Pyoderma gangrenosum of the scalp treated with cyclosporine A

A 56‐year‐old woman presented with an ulcer, with a depth of 9 mm, on the vertex and frontal parietal regions of the scalp. The lesion had a round shape (diameter, 7 cm), with clear‐cut margins and vertical borders sinking vertically to a bottom that was entirely covered with purulent fibrinous yellowish matter and greenish colored necrotic tissue. Other numerous small roundish ulcers were present next to the large ulcer. These had irregular margins with a yellowish fibrinous bottom ( Fig. 1 ). The patient reported the appearance of two small ulcers on the left and on the right frontal parietal regions about 1 year earlier. These had been treated locally with antimicrobials and antiseptics with no result. During the 2 months prior to our evaluation, a few small round‐shaped ulcers had appeared on the scalp. These had progressively increased in size and number.

Absence of clinical and dermoscopic differences between congenital and noncongenital melanocytic naevi in a cohort of 2-year-old children.

Background  Congenital melanocytic naevi (CMN) are present at birth. Some naevi, tardive congenital naevi (TCN), become clinically apparent only after birth, during the first years of life. The number of naevi continues to increase due to the appearance of acquired melanocytic naevi (AMN). When AMN begin to appear has not been well defined.

Response of cutaneous microcirculation to treatment with mometasone furoate in patients with psoriasis

Background.  In patients with psoriasis, videocapillaroscopy has been used to visualize the typical modifications in the microcirculatory architecture.

Ulcerated necrobiosis lipoidica treated with cyclosporin A

Sir, Necrobiosis lipoidica (NL) is a skin disease of unknown aetiology. It is a relatively rare cutaneous complication of diabetes mellitus, occurring in 0.3% of manifest diabetics (1). The course of NL appears unrelated to duration of the diabetes or to adequacy of the diabetic control. There may be a correlation with diabetic micro-angiopathy (1). NL is characterized by sharply demarcated, smooth surfaced, irregularly shaped plaques of atrophic skin varying in colour from yellowish to reddish brown. The usual location is the anterior lower part of the leg, often bilaterally, but lesions can be seen on the thighs, popliteal areas and feet. The arms, trunk, face and scalp may be affected, but only in rare cases (1). A complication of the more extended lesions is ulceration, which often occurs following trauma and heals with difficulty leaving scars. At present there is no treatment that can be considered satisfactory, although numerous therapeutic protocols have been proposed. The ulcerated forms may need surgical treatment with excision of the affected areas and subsequent grafting. Recently, there have been reports of good results obtained with the use of cyclosporin A (CyA) (2, 3).