European Journal of Dermatology最新文献

Sun exposure is the main external risk factor for skin cancer, affecting melanoma and non-melanoma differently. Although increased awareness of sun-induced skin damage and appropriate photoprotection has helped to reduce melanoma incidence, inadequate sun protection persists, influenced by geographical, social, and cultural factors. Italy's varying climates -from the colder north to the warmer south- impact sun exposure behaviours. This study examined sun protection habits from the 2023 "Save your skin" campaign to identify at-risk groups and support targeted education. Participants completed anonymous questionnaires on sun exposure, sunscreen use, and skin cancer history. Among 1,773 participants, 45% spent 2-4 weeks per year in the sun on holiday, 26% experienced occupational sun exposure, and 33% used tanning beds. Despite darker skin types, only 26% tanned easily; severe sunburn rates were consistent across regions. Central and southern participants reported more sun exposure on holiday than northern participants (p < 0.001); work-related sun exposure was more common in the south. Tanning bed use was higher in the north (p < 0.001). Although 62.46% always used sunscreen, only 32.51% applied it correctly. Misconceptions about sunscreen were widespread, and actinic damage was more frequent among those with lower photoprotection awareness. Inadequate sun protection is widespread in Italy, with regional differences in sun exposure and tanning bed use. Misconceptions about sunscreen are common, and the rate of proper application is low. The higher incidence of actinic damage among those with less photoprotection knowledge highlights the need for targeted education to improve sun safety and reduce skin cancer risk.

Keratosis pilaris is a benign and prevalent dermatological condition, clinically characterized by erythematous and hyperpigmented papules with a rough texture. Its appearance on exposed areas, such as the extensor surfaces of upper arms, can lead to psychosocial distress. Despite the range of available topical and laser therapies, no standardized approach exists for selecting one treatment over another. This updated systematic review aims to provide innovative strategies for the therapeutic management of common keratosis pilaris. Twenty-seven articles published between 2011 and 2024 were included. The selected studies comprised monotherapies (topical or laser), comparative analyses, and combination treatments. Lactic and glycolic acids were the preferred topicals, demonstrating efficacy in the treatment of keratosis pilaris. The Nd:YAG laser yielded consistently favourable outcomes. Among ablative lasers, the CO2 laser showed efficacy, while the erbium:YAG appeared promising due to fewer adverse effects. The management of keratosis pilaris involves a multimodal strategy centred on patient education, topical treatments and laser therapies. To address the diverse clinical features of the condition, we propose a stepwise, stratified therapeutic approach.

Dystrophic epidermolysis bullosa (DEB) is a clinically heterogeneous blistering disease caused by pathogenic variants in the COL7A1 gene. Phenotypes range from localized to generalized and are primarily determined by the variant type, though additional modifiers influence disease severity. To characterize the molecular basis of the disease phenotype in a diabetic patient presenting with localized skin blistering and nail dystrophy. Skin biopsies were taken from the index patient for immunofluorescence mapping and keratinocyte culture. Exome sequencing was used to screen for pathogenic variants and Sanger sequencing for variant segregation in family members. COL7A1 mRNA and protein studies were performed by reverse transcriptase-PCR analysis and western blot. Advanced glycation end products in skin were analysed by confocal immunofluorescence microscopy. Molecular analysis identified a heterozygous COL7A1 splice variant, c.5053-1G>C, which resulted in both an exonic deletion and an intronic insertion with decay of the mutant transcripts, leading to about half of the normal levels of mRNA and protein in the patient's keratinocytes. Although the diabetic proband was the only family member developing recurrent skin blisters, great toenail dystrophy segregated with the variant in the offspring. Functional COL7A1 haploinsufficiency is therefore the most likely mechanism for the segregation of this mild DEB trait in the family. Increased protein glycation was detected in the proband's skin. The effects of the mutation and increased protein glycation in the proband's skin suggest a concurrent effect of diabetic dermopathy and COL7A1 pathology on skin fragility.