Dermatology Reports最新文献

Bier's spots are rare angiospastic macules often associated with physiologic vasoconstriction. This case report describes a 35-year-old man with chronic myeloid leukemia treated with nilotinib who developed Bier's spots, a previously unreported adverse effect of the drug. The patient presented with asymptomatic hypopigmented macules on the hands and legs that appeared during venous stasis and resolved with elevation. This case emphasizes the need to recognize potential vascular side effects of tyrosine kinase inhibitors and highlights Bier's spots as a benign but remarkable manifestation in patients undergoing nilotinib therapy.

Petrified ear is a rare clinical entity characterized by the progressive hardening of normal flexible auricular cartilage, leading to partial or complete auricular stiffness. In many cases, it provides a valuable clinical clue that allows the clinician to detect endocrinopathies (particularly Addison's disease) in a patient who has not received a diagnosis. We present the first documented case of petrified ears, which resulted in the diagnosis of both secondary hypoadrenalism and growth hormone deficiency (GHD). Additionally, we review the relevant literature. Petrified ears syndrome is probably an underreported clinical manifestation of other systemic disorders. It may, at times, serve as a useful and simple clinical clue to suspect underlying endocrinopathies even in the absence of typical features.

Various studies have shown that individuals with bullous pemphigoid (BP) are more likely to develop venous thromboembolism (VTE). However, it is important to acknowledge that these studies primarily focused on individuals in Western nations, which restricts their generalization to a wider demographic. The present systematic review aims to assess the cumulative risk of VTE in individuals with BP compared to healthy individuals. PubMed, Cochrane, and Scopus databases were searched for evidence-based research papers on BP and VTE. Eligibility criteria were based on the PICOS criteria. The Newcastle-Ottawa scale assessed methodological quality. After database searches, 115 studies meeting the inclusion criteria were identified. A manual inquiry yielded an additional 11 articles. After removing duplicates (n=54), 72 publications underwent title and abstract evaluation, resulting in the exclusion of 44 manuscripts. Consequently, the remaining full-text articles were thoroughly examined. Following full-text screening, 9 publications were included. The studies were conducted in Denmark, the USA, the UK, Taiwan, and Italy. The findings enhanced the generalizability of the correlation between VTE and BP. Individuals with systemic autoimmune diseases were found to have a 1.5 to 4 times higher likelihood of developing VTE. The analysis revealed that patients with pemphigus face a twofold higher risk of VTE, especially within the first few years after diagnosis. These results may enhance the recognition of pulmonary embolism in BP patients and motivate the prevention of secondary risk markers associated with VTE. Given the morbidity, VTE risk in BP patients warrants greater attention in public healthcare.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but serious cutaneous reactions characterized by epidermal and mucocutaneous detachment, most often drug-induced. SJS and TEN are considered the opposite extremes of the same spectrum of disease, where the percentage of skin involvement is <10% in SJS and >30% in TEN; the in-between range is called a SJS/TEN overlap. We present the case of a 64-year-old patient who was treated with lamotrigine, an anti-epileptic drug, and developed SJS/TEN. After being hospitalized and recovering for three days due to the worsening of the clinical presentation, he was transferred to a burn center. Making an early diagnosis and identifying the indicated drug is extremely important to set the appropriate treatment and reduce mortality. Advanced supportive care is required.

Isotretinoin, widely used for treating severe acne, has also been prescribed off-label for hidradenitis suppurativa (HS). While effective in some cases, isotretinoin is known to cause psychiatric side effects. This case report discusses a 24-year-old male with HS who developed severe nightmares after isotretinoin dosage was increased. Initially prescribed to manage his HS symptoms, the drug led to vivid, distressing nightmares that significantly disrupted his sleep, resulting in the discontinuation of treatment. The symptoms resolved upon cessation of isotretinoin, and a probable association was confirmed using the Naranjo algorithm. The patient was later transitioned to adalimumab, a biologic therapy for HS. This case highlights the need for careful psychiatric monitoring during isotretinoin therapy and emphasizes the importance of considering alternative treatments in cases of intolerable side effects. Further research is necessary to understand better the psychiatric implications of isotretinoin, including sleep disturbances like nightmares.

Skin cancer incidence is increasing worldwide. Clear communication between dermatologists and histopathologists, along with the possibility of sharing clinical images, is critically important. This survey aims to depict the level of communication between dermatologists and histopathologists in clinical practice in Italy. A group of histopathologists participating in monthly online meetings were recruited to participate in our survey. We collected information regarding dermatologists' habits in providing or not providing clinical and dermatoscopic images of melanocytic/keratinocytic lesions. A total of 63 histopathologists agreed to participate. Fewer than 15% of histopathologists receive routine clinical or dermatoscopic images from dermatologists after the surgical excision of a melanocytic lesion, while clinical and dermoscopic images of non-melanoma skin cancers are sent in fewer than 10% of cases. Our survey revealed that, in Italy, the communication between dermatologists and pathologists is far from being optimal.

Dear Editor, Dermatitis factitia (DF), also known as dermatitis artefacta, is a rare condition characterized by self-inflicted skin lesions. These lesions can be a result of compulsive habits driven by emotional distress, serving as a means of emotional release during episodes of anxiety or distress. Alternatively, they may be deliberately induced by the patient with the intention of gaining medical attention. DF is essentially the physical manifestation of underlying psychiatric disorders, making it a particularly challenging condition within the realm of medical practice. Being a diagnosis primarily based on the exclusion of an underlying disorder often requires multiple investigations that can impose a significant economic burden. [...].

The large language model (LLM) ChatGPT can answer open-ended and complex questions, but its accuracy in providing reliable medical information requires a careful assessment. As part of the AICHECK (Artificial Intelligence for CME Health E-learning Contents and Knowledge) Study, aimed at evaluating the potential of ChatGPT in continuous medical education (CME), we compared ChatGPT-generated educational contents to the recommendations of the National Institute for Health and Care Excellence (NICE) guidelines on acne vulgaris. ChatGPT version 4 was exposed to a 23-item questionnaire developed by an experienced dermatologist. A panel of five dermatologists rated the answers positively in terms of "quality" (87.8%), "readability" (94.8%), "accuracy" (75.7%), "thoroughness" (85.2%), and "consistency" with guidelines (76.8%). The references provided by ChatGPT obtained positive ratings for "pertinence" (94.6%), "relevance" (91.2%), and "update" (62.3%). The internal reproducibility was adequate both for answers (93.5%) and references (67.4%). Answers related to issues of uncertainty and/or controversy in the scientific community scored the lowest. This study underscores the need to develop rigorous evaluation criteria for AI-generated medical content and for expert oversight to ensure accuracy and guideline adherence.

Capillary malformations are the most prevalent low-flow vascular abnormalities. A case of a 30-year-old woman with lateral capillary malformation was presented in this case report. Dermoscopic showed erythematous background and rare telangiectasic vessels for less than 5-10% of the entire area examined. She underwent a single treatment with a 595 nm pulsed dye laser. Excellent response at the end of the session and a clear reduction of the capillary malformation at clinical follow-up 2 months later was achieved. Dermatoscopic and 3D photographic evaluation before and after laser treatment also documented the disappearance of the erythematous background and telengectasic vessels.

Lichen sclerosus (LS) is a chronic scleroatrophic dermatosis of unknown etiology that usually affects the anogenital area and occasionally the extragenital sites, which has no definitive cure. LS patients are at higher risk of developing squamous cell carcinoma (SCC) in their lifetime compared to the general population. Through a retrospective study, we evaluated the impact of regenerative medicinebased therapies on SCC onset in the context of genital LS. LS patients treated in our institute from March 2013 to December 2022 were reviewed. A total of 319 patients, including 34 treated with adipose-derived stem cells (ADSCs) graft, 31 treated with ADSCs graft and PRP, and 254 treated with platelet-rich plasma (PRP) were identified. In parallel, data extracted from the histologic institutional database searching for SCC in the anogenital area were matched to surgical records. None of the 319 LS patients developed skin SCC in the anogenital area. Our data suggest that cellular and acellular therapies achieving therapeutic control prevent continuous tissue remodeling and its evolution and, therefore, neoplastic degeneration. Regenerative approaches are considered a valid strategy for treating LS patients symptomatic despite prolonged first-line medical treatment. Studying genital carcinogenesis of LS cases, we reported for the first time a protective role of PRP, ADSCs, and combined therapies. Thus, in terms of cancer prevention, we propose that regenerative therapies ameliorating disease control of non-responders to conventional therapy represent an important innovative tool.