Stefano Veraldi

Evaluation of efficacy of a skin lipid mixture in patients with irritant contact dermatitis, allergic contact dermatitis or atopic dermatitis: a multicenter study

Disturbances of skin barrier function occur in several skin diseases, e.g., atopic dermatitis (AD), irritant/allergic contact dermatitis (ICD, ACD). Skin barrier damage triggers the production of cytokines that stimulate lipogenesis which may also cause inflammatory processes. The aim of this study was to evaluate the efficacy of a topical skin lipid mixture in the treatment of ICD, ACD and AD. 580 consecutive patients suffering from ICD, ACD or AD were treated with a skin lipid mixture containing ceramide‐3 and patented nanoparticles. Patients received the lipid mixture alone or in combination with topical corticosteroids until clearance or for 8 weeks. Both treatment groups statistically improved all parameters considered at week 4 and 8 as compared to baseline. Between the 2 treatment groups, there was a statistically significant difference in favour of combined therapy for (ICD, ACD, AD, respectively): erythema, pruritus and overall disease severity; erythema and pruritus; erythema, pruritus, fissuring and overall disease severity. No statistically significant difference was found for (ICD, ACD, AD, respectively): dryness, scaling and fissuring; scaling, fissuring and overall disease severity; dryness and scaling. Between the 2 ACD treatment groups, there was a statistically significant difference in favour of the skin lipid mixture for dryness. In conclusion, the study shows that balanced lipid mixtures are effective in improving barrier properties and the clinical condition of the skin in contact dermatitis.

Laugier-Hunziker syndrome: A clinical, histopathologic, and ultrastructural study of four cases and review of the literature

Four cases of Laugier-Hunziker syndrome are described. In all patients (two men and two women between 39 and 57 years of age) pigmentation of the lower lip and hard palate was found. in addition, two patients had involvement of the buccal mucosa; another patient also had pigmentation of the upper lip, the gums, the soft palate, and the fingers of both hands. Histopathologic examination demonstrated an accumulation of melanin in the basal layer keratinocytes and an increase in the number of melanophages in the papillary dermis. Ultrastructural study showed the presence of numerous mature melanosomes in the cytoplasm of the keratinocytes of the basal layer and of the melanophages in the papillary dermis. Alterations of the melanocytes were not observed.

Imported tungiasis: a report of 19 cases and review of the literature

Tungiasis is an infestation caused by penetration in the skin of the gravid female of the flea Tunga penetrans. In the period 1991–2006, 19 patients with imported tungiasis were observed at our Institute. All patients were subjected to general and dermatological examination, laboratory tests (including bacteriological examinations) and surgical excision of the lesions with histopathological examination. In all patients tetanus prophylaxis was made. All patients were followed up for at least six weeks. Thirteen patients were males (68.4%) and 6 females (31.6%). The age ranged from 3 to 71 years (average age: 37.8 years). Eleven patients (57.9%) contracted the infestation in Central and South America and 8 (42.1%) in Africa. In 17 patients (89.5%) tungiasis was localized to the feet, in one to the hands and in one to a thigh. In 13 patients (68.4%) the infestation was characterized by a single lesion; in the other 6 patients (31.6%) the lesions were two. In 15 patients (78.9%) tungiasis was characterized by a papular or nodular lesion. Crusted (2 patients), pustular (2 patients) and bullous (1 patient) lesions were also observed; furthermore, one patient presented with a plantar wart‐like lesion. In only one patient bacteriological examinations showed the growth of Staphylococcus aureus and Escherichia coli. All patients healed without complications.

Erosive pustular dermatosis of the scalp

Three cases of erosive pustular dermatosis of the scalp are reported. In all patients the dermatosis was characterized by pustular, erosive, and crusted lesions; in addition, two patients had areas of scarring alopecia. The results of laboratory tests, bacteriologic and mycologic investigations, and histopathologic examination were nondiagnostic. Although erosive pustular dermatosis of the scalp is characterized by a nonpathognomonic clinical and histopathologic picture, it probably represents a disease entity.

Albendazole: a new therapeutic regimen in cutaneous larva migrans

Background Various therapeutic modalities have been used to treat cutaneous larva migrans, including physical treatments (cryotherapy), topical drugs (tiabendazole), and systemic drugs (tiabendazole, albendazole, and ivermectin). Physical treatments are often ineffective and not devoid of side‐effects. Topical tiabendazole is difficult to find in many countries; it is effective orally but frequently causes side‐effects. Ivermectin has been used in a small number of patients.

Erysipeloid: a review.

Erysipeloid is an occupational infection of the skin caused by traumatic penetration of Erysipelothrix rhusiopathiae. The disease is characterized clinically by an erythematous oedema, with well‐defined and raised borders, usually localized to the back of one hand and/or fingers. Vesicular, bullous and erosive lesions may also be present. The lesion may be asymptomatic or accompanied by mild pruritus, pain and fever. In addition to cutaneous infection, E. rhusiopathiae can cause endocarditis, which may be acute or subacute. Endocarditis is rare and has a male predilection. It usually occurs in previously damaged valves, predominantly the aortic valve. Endocarditis does not occur in patients with valvular prostheses and is not associated with intravenous drug misuse. Diagnosis of localized erysipeloid is based on the patient’s history (occupation, previous traumatic contact with infected animals or their meat) and clinical picture (typical skin lesions, lack of severe systemic features, slight laboratory abnormalities and rapid remission after treatment with penicillin or cephalosporin).

CUTANEOUS MYIASIS CAUSED BY LARVAE OE CORDYLOBIA ANTHROPOPHAGA (BLANCHARD)

Background. Cordylobia anthropophaga (Blanchard) is a nonhematophagous dipteron belonging to the Calliphoridae family. It produces a mylasis called “tumbu fly” or “ver de Cayor” or “mango fly” or “skin maggot fly.”

Treatment of mild to moderate seborrhoeic dermatitis with MAS064D (Sebclair®), a novel topical medical device: results of a pilot, randomized, double-blind, controlled trial

Aim  MAS064D (Sebclair®) is a novel steroid‐free cream containing multiple active ingredients. Objective of this pilot study was to evaluate the efficacy and safety of MAS064D in the treatment of mild to moderate SD of the face.

Contact urticaria from kiwi fruit.

A 30-year old woman had a 6-month history of cheilitis accompanied by a burning feeling in the mouth. She had previously been treated with topical corticosteroids and antiseptic mouthwashes, which had produced only temporary benefit. A careful history revealed that, some minutes after eating fruit, swelling of the lips appeared, accompanied by pruritus, swelling of the tongue, and a burning sensation in the mouth. Open tests were performed on both intact and scratched skin, with the pulp of fruits usually eaten by the patient. At the site of scratched skin on which the pulp of kiwi fruit (Actinidia chinensis: also known as chinese gooseberry) was applied, we observed a marked erythemato-oedematous reaction after 10 min. The kiwi fruit did not provoke any reaction on intact skin. All other fruits tested gave negative results on both intact and scratched skin. Discussion

Tungiasis in a 3-year-old child

Abstract: Tungiasis is an infestation of the skin caused by the flea Tunga penetrans. It is not rare in western Europe because of tourism to tropical and subtropical countries. However, tungiasis has been very rarely reported in children. We describe a case of tungiasis in a 3‐year‐old child. The infestation was localized to the second toe of the left foot and was characterized by an atypical clinical presentation.