Dermatology practical & conceptual最新文献

Introduction: Soon after birth, the clinical differential diagnosis between sebaceous of Jadassohn (NSJ), congenital triangular alopecia (CTA) and aplasia cutis congenita (ACC) may be challenging. A certain overlap of standard dermoscopic features can occur, especially in atypical cases, depending on scalp skin morphology and maturation age. The recently developed line-field confocal optical coherence tomography (LC-OCT) can provide morphological skin details with cellular resolution trough a rapid non-invasive examination.

Objectives: To assess the LC-OCT features of 6 cases of congenital alopecia of different aetiologies, with both typical and atypical clinical appearance.

Methods: A non-invasive imaging examination combining standard dermoscopy, high-resolution videodermoscopy (HRVD) and LC-OCT was realized in 7 babies presenting for congenital alopecia with overlapping features, aged between 5 months and 5 years.

Results: Based on the specific LC-OCT features, and supported by HRVD features, a diagnosis of NSJ, congenital triangular alopecia (CTA) and AC) were made in 4, 2 and 1 case, respectively.

Conclusions: The combined LC-OCT plus HRVD non-invasive imaging bring the advantage to have a real time diagnosis, to set the proper management and allows to avoid a skin biopsy in the perinatal age/first years of life at delicate skin site.

Introduction: Hailey-Hailey disease (HHD) is a rare inherited blistering skin disorder characterized by a chronic relapsing course. While it does not pose a serious threat to the patient's health, the quality of life can change. Unfortunately, there is currently no standard treatment for this condition.

Objectives: In this observational retrospective cohort study, our aim was to discover the demographic characteristics and treatment strategies for managing HHD.

Methods: In this retrospective cohort study, we documented the demographic, clinical, and histopathological characteristics beside various treatment employed options of patients diagnosed with HHD at Razi Hospital over the past 14 years.

Results: A total of 32 patients with HHD were enrolled in the study (15 male and 17 female). The mean age of patients was 50.41 ± 13.15 (22-77) years. The average age of disease onset was 37.31 ± 11.88 (15-60) years. Among the participants, 16 individuals (50%) affirm a positive family history of some kind of pemphigoid blisters. The most common site of disease activity was the inguinal area, observed in 14 patients (33.33%). Histopathological examination discovered the existence of suprabasal acantholysis in all of the specimens. Worthily, direct immunofluorescence analysis showed negative results in all skin biopsies. All patients received topical steroids and either topical or systemic antimicrobial agents. In cases of flares, systemic steroids were the most popular and favorable treatment choice during flares.

Conclusion: Indeed, Hailey-Hailey disease, characterized by its chronic inflammatory and rare nature with a relapsing and remitting course, poses a significant challenge for dermatologists. The treatment of HHD has been less than satisfactory and it often presents a challenge and could be misdiagnosed. Among the available treatment options, topical steroids and antimicrobial agents are the most administered therapies.

Introduction: Stage IIA cutaneous melanoma is typified by a Breslow thickness between 1.1 and 2.0 mm with ulceration or between 2.1 and 4.0 mm without ulceration. The role of radiological investigations in staging and follow-up of this intermediate-risk subgroup of patients is still debated.

Objectives: The aim of this study is to investigate the role of imaging procedures in the follow-up of stage IIA melanoma asymptomatic patients.

Methods: Data were retrieved from two tertiary referral centers in Italy. Among patients with stage IIA melanoma, those who relapsed were investigated concerning type of detection (by patient or by doctor), and modality of detection (clinical examination, ultrasound, CT scan). In addition, false positive data were collected.

Results: In total, 213 patients were retrieved, with 26 patients showing relapse (recurrence rate, 12.2%). The mean follow-up time was 3 years and the mean time to recurrence was 17.8 months. 21/26 (80.7%) recurrences were identified by the doctor and 5/26 (19.2%) by the patient (P < 0.05). Among those identified by the doctor, 16/21 (76,1%) were identified by radiological examinations. Nine out of 15 (60%) lymph node recurrences were detected by ultrasound and 6/7 (85.7%) distant metastases were detected by CT. The false positive rate was 7% (P < 0.05).

Conclusions: In our study the great majority of metastases were detected using imaging procedures. Given the new therapeutic options offered by targeted therapy and immunotherapy in relapsing patients, the role of radiological investigations in the follow-up of stage IIA patients should be reconsidered.

Introduction: Children's skin is particularly susceptible to the carcinogenic effects of ultraviolet radiation. Young children are dependent on sun protection measures taken by parents and other caregivers.

Objectives: The aim of the study is to evaluate parental sun protection behavior and sun protection measures at preschool at two points in time (2010/11 and 2018/19) in Bavaria and to test for a secular trend.

Methods: Two cross-sectional surveys were carried out. For each survey, more than 4,000 parents of preschoolers completed a self-administered questionnaire about parental sun protection behavior and sun protection measures at preschool. To identify possible associations between parental sun protection behavior and sociodemographic characteristics, logistic regression analysis was carried out.

Results: In the survey of 2018/19, six out of eight sun protection measures are adequately applied by over two-thirds of the parents. Two out of eight sun protection measures are adequately applied by less than one-third of the parents. Those two measures are aligning sun protection to actual UV index and preschoolers wearing sunglasses. The comparison of the study population of the survey of 2010/11 and of 2018/19 shows an improvement in parental sun protection behavior for seven out of eight sun protection measures. In both surveys more than 80% of parents state that preschool staff ensures preschoolers wear sun hats and sunscreen outside on sunny days.

Conclusions: Future campaigns should focus on the use of sunglasses and promote the UV index, as these sun protection measures are used very little.