Italian Journal of Dermatology and Venereology最新文献

Pyoderma gangrenosum is a rare, ulcerative neutrophilic dermatosis of yet unknown origin. While advances have been made into the mechanisms underlying PG, our understanding is limited by a paucity of research and funding into this condition. This review highlights the current landscape of PG pathogenesis, diagnosis, and treatment in the hopes of encouraging additional scientific inquiry into this rare, severe condition.

Keloids are an aberrant fibroproliferative response to wound healing of the skin, leading to scar tissue that expands above and beyond the original cutaneous injury. Keloids can be difficult to treat because of their tendency to recur after treatments, including after excision. There is a myriad of treatment modalities used, which can be used as monotherapy or in combination with surgical excision or other treatment methods. This review covers many treatment approaches including surgical excision, compression, silicone sheets, steroid-impregnated tape, imiquimod, intralesional injections, cryotherapy, laser, radiation, pentoxifylline, and dupilumab.

Background: The aim of this study was to assess the degree of agreement among pediatric dermatologists in Tuscany concerning different aspects of scabies infestation management in children, employing the Delphi method.

Methods: We conducted a Delphi study involving ten pediatric dermatology centers in Tuscany, Italy. Questionnaires were distributed to a panel of experts anonymously. The questionnaires were organized into six specific topics: "diagnosis," "hygiene measures," "application of topical products," "treatment," "treatment of exposed individuals," and "clinical follow-up after therapy." Each question within these topics offered six different response options.

Results: All participating dermatologists completed the two-round questionnaire. Full consensus was reached for all statements related to "diagnosis," "hygiene measures," "treatment of exposed individuals," "application of topical products," and "clinical follow-up after therapy," since each statement met the predetermined consensus threshold of 70% or higher. However, we could not achieve a substantial consensus on the treatment of scabies, aside from agreement on the lower efficacy of permethrin therapy.

Conclusions: Considering the growing recognition of Sarcoptes scabiei resistance to conventional permethrin therapy, this regional consensus offers clear insights into the overall management of scabies. However, it also reveals that each dermatologist primarily relies on their own experiences for medical treatment, which may not be universally shared among colleagues. This emphasizes the urgent necessity for updated guidelines on therapeutic strategies.

Hidradenitis suppurativa has greatly benefited from the insights of color Doppler ultrasound. Thus, ultrasonography has helped prove the follicular link of this disease and has ruled out the primary involvement of the apocrine glands, which, in the old days, was supposedly the cause of the disease. Importantly, ultrasound can detect subclinical anatomical information in HS that cannot be deducted from the clinical examination. Moreover, high-frequency (≥15 MHz) and ultra-high-frequency (≥50 MHz) ultrasound present a much higher axial spatial resolution compared to magnetic resonance imaging. Ultrasound allows us to detect better subclinical cutaneous anatomical abnormalities and, therefore, arrive earlier and more accurately at diagnosis and staging. Ultrasonographic diagnostic criteria can discriminate HS from other clinical simulators, which is also critical in diagnosing mild and moderate stages and is relevant for the severe stages. This imaging technique supports the severity (mSOS-HS) and activity (US-HSA) scorings more accurately, which can help assess the actual stage of the disease. This is important to decide the type of treatment and to perform a more objective follow-up of the patients. Magnetic resonance imaging has been reported as helpful in diagnosing deep perianal tunnels; however, it presents a lower axial spatial resolution compared with high and ultra-high frequency ultrasound. Nowadays, there is solid evidence of the usefulness of ultrasound in HS, which implies that it is a game-changer and should be recommended as the first-choice imaging technique and a standard of care tool for HS patients.

Sweet syndrome is a neutrophilic dermatosis characterized by an autoinflammatory nature and a sterile neutrophilic infiltrate. It presents with tender, erythematous, edematous papules or plaques, often accompanied by fever. Aim of this review is to summarize the most meaningful aspects of Sweet syndrome, critically discussing old paradigms and novel findings. A search of the English-language literature was conducted using the terms "Sweet syndrome" and "acute febrile neutrophilic dermatosis." MEDLINE (via PubMed) and Web of Science (WOS) databases were consulted up to June 30, 2024. Since its first identification, new clinical and histopathological variants of Sweet syndrome have been described, highlighting its heterogeneity. Additionally, a multitude of clinical conditions have been increasingly reported in association with Sweet syndrome, ranging from malignancies, autoimmune and infectious disorders. The pathogenesis of the disease is unclear and varies according to the associated conditions. One unifying mechanism is the aberrant activation, proliferation, and skin homing of neutrophils. The mainstay of treatment remains systemic corticosteroids; alternatives include colchicine, dapsone, and potassium iodide. Traditional immunosuppressants, biologic agents, and small molecules have also been described as effective in treating Sweet syndrome. Sweet syndrome is a heterogeneous condition with an elusive pathogenesis. Most cases resolve with corticosteroids, but some remain refractory to various therapies, representing an unmet medical need. Recent evidence on the pathomechanisms underlying Sweet syndrome suggests that not only innate but also adaptive immunity might play roles. Further experimental studies are needed and may help identify new therapeutic targets in the future.

Background: Some people may compulsively desire to suntan despite the negative consequences, exhibiting symptoms similar to addictive disorders. Tanning dependence (TD) should be considered a risk factor leading to excessive sunbathing and thus increasing the risk of skin cancers. The aim of the present study was to investigate the tanning habits of the inhabitants of Trieste, a Northeastern Italian town characterized by high melanoma incidence. Predictors of tanning addiction were searched. The area of Trieste ranks second in Italy (after Turin) for melanoma incidence with standardized incidence rates very high in both sexes.

Methods: This study was based on an anonymous online survey of 520 randomly recruited adults who reported living in Trieste. TD was assessed using the mCAGE (modified Cut down, Annoyed, Guilty, Eye-opener) and the mDSM-IV-TR (modified Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) questionnaires. Participants were classified as TD if positive on both questionnaires.

Results: Seventy-eight (15%) individuals were classified as TDs. The analyses compared TDs (N.=78, 15%) with non-TDs (N.=285, 55%) on various characteristics and behaviors. Females were significantly more represented in the TD group than males (P=0.03). Contrarily, TD did not vary with respect to age and Fitzpatrick skin type. High-risk tanning behaviors, including sun exposure in the middle hours of the day, long tanning sessions (more than 3 hours), and the use of sunbeds, were significantly related to TD.

Conclusions: Our results show that TD can be predicted by tanning behaviors. Increased knowledge of TD will help design appropriate interventions for different risk subgroups.