Italian Journal of Dermatology and Venereology最新文献

There are differences in the use of antiseptics and disinfectants. Antiseptics inhibit the growth and development of microorganisms on living tissues and are used for preoperative skin preparation, wound cleansing, and the treatment of superficial skin infections. In contrast, disinfectants reduces microbial contamination in the vegetative phase on inert materials, such as surfaces and medical devices. Disinfectants and antiseptics are irritants, especially when used in high concentrations, over prolonged periods, or on damaged skin. Additionally, many of them may have sensitizing potential, which is likely underestimated. Allergic contact dermatitis can only be diagnosed through a careful anamnesis and appropriate patch tests. These review provides an overview of the main disinfectants and antiseptics, highlighting their properties to aid in appropriate selection and minimize adverse effects. Benzalkonium chloride, cetrimide, sodium hypochlorite, ethyl and isopropyl alcohol are described for their use as both disinfectants and antiseptics. Other disinfectants discussed include glutaraldehyde, phenols, peracetic acid. Among the antiseptics, povidone-iodine, chlorhexidine, hydrogen peroxide, mercurochrome/merbromine, silver-based dressings and triclosan are also reviewed. This article presents a literature review of major studies published in English up to december 2024. The electronic search was conducted using the PubMed database of the US National Library of Medicine. We discuss recent findings on these antiseptics and disinfectants, which are widely used.

Introduction: Mpox (formerly monkeypox), caused by the monkeypox virus (MPXV), has historically been confined to parts of Central and West Africa. However, recent outbreaks in non-endemic regions (2022-2024) revealed efficient transmission within sexual networks and a broad range of cutaneous and mucosal presentations. The aim of this review is to summarize key aspects of Mpox, including its epidemiology, pathogenesis, clinical features, diagnosis, treatment, and public health strategies for outbreak control.

Evidence acquisition: A systematic literature search in PubMed until December 2024 was conducted using terms such as "monkeypox,", "mpox", "orthopoxvirus," and "skin lesions". Selected articles pertinent to dermatological clinical features, diagnostic methods, management, and prevention strategies were reviewed.

Evidence synthesis: While Mpox often presents with characteristic vesiculopustular lesions, the 2022 outbreak underscored frequent anogenital localization mimicking other sexually transmitted infections. Confirmatory testing via PCR remains essential, and supportive care suffices for most immunocompetent individuals. In severe or immunocompromised cases, antivirals like tecovirimat can shorten disease duration. Vaccination campaigns with Modified Vaccinia Ankara (MVA-BN) successfully reduced incidence in high-risk populations. Emerging evidence from Dermatology journals emphasizes atypical morphologies - hemorrhagic, necrotic, and bullous variants - in both immunocompetent and immunocompromised patients.

Conclusions: Cutaneous Mpox presents diagnostic and therapeutic challenges for dermatologists and venereologists, particularly when lesions deviate from classical patterns. Continued research on vaccine durability, combination antiviral therapies, and long-term cutaneous sequelae will refine future outbreak responses and patient care.

Atopic dermatitis is the most common chronically or chronically relapsing inflammatory skin disease, characterized by intense pruritus, eczematous lesions, and a significant disease burden. Emerging evidence in recent years suggests that atopic dermatitis and the associated chronic systemic inflammation have health implications beyond the skin. For psoriasis, another chronic inflammatory skin disease, the association with cardiovascular diseases (CVDs) is well-established. Recent studies have demonstrated a similar association between atopic dermatitis and CVDs such as hypertension, atherosclerosis, myocardial infarction, and major cardiovascular events. CVDs are the leading cause of death in the USA and Europe, and information about a heart-healthy lifestyle for patients at heightened risk is important. This narrative review focuses on recent studies investigating the association between atopic dermatitis and hypertension, ischemic heart disease including myocardial infarction and coronary heart disease, cardiac arrhythmias, and the association between atopic dermatitis, cardiovascular diseases, and a sedentary lifestyle. The associations between atopic dermatitis and CVDs appear to be more pronounced for moderate to severe disease across all included cardiovascular conditions in this review, suggesting a potential impact from systemic inflammation linked to atopic dermatitis. However, it remains uncertain whether the increased cardiovascular risk is directly attributable to the inflammatory nature of atopic dermatitis or may result from reduced physical activity commonly seen in these patients.

Introduction: Reticular erythematous mucinosis (REM) is a rare chronic dermatosis, predominantly affecting middle age women, characterized by net-like macules and patches on the chest and back. The etiology of REM is uncertain, though associations with environmental, hormonal, and autoimmune factors have been suggested.

Evidence acquisition: This systematic review of 62 studies, involving 129 patients, analyzes the clinical, histopathological, and therapeutic aspects of REM.

Evidence synthesis: Findings indicate consistent mucin deposition in the dermis, a predominant lymphocytic infiltrate, and a frequent association with comorbidities like thyroid disorders and autoimmune diseases. Antimalarial medications, particularly hydroxychloroquine, are highlighted as the most effective treatment, though the disease may relapse upon cessation.

Conclusions: This review emphasizes REM as a distinct clinical entity and underscores the need for further research to refine diagnostic criteria and treatment protocols.

Background: Psoriasis is a chronic, immune-mediated inflammatory disease with a prevalence of 2-3% in the general population and 0.7-1.2% among children in Western countries. It is often associated with comorbidities, particularly cardiovascular and metabolic diseases. This study aims to investigate the correlation between the onset of psoriasis during childhood (COP) and the prevalence of cardiovascular and metabolic comorbidities in adulthood, focusing on patients aged 30-50 years.

Methods: A cross-sectional, multicenter study was conducted involving 1922 psoriasis patients from 12 centers across Türkiye. Data collected included demographic information, disease characteristics, cardiovascular and metabolic comorbidities, laboratory parameters, and treatment history. Metabolic syndrome (MetS) was diagnosed based on established criteria, and logistic regression analysis was used to identify factors associated with comorbidities.

Results: Among the patients, 34.5% had the onset of psoriasis before the age of 18. The average duration of the disease was 28.28±53.42 years. The prevalence and age of onset of MetS were similar in both COP and AOP groups. Although the onset age of obesity was earlier in COP patients, no direct connection between the onset of psoriasis and obesity prevalence was established. Total cholesterol, LDL-cholesterol, and HOMA-IR levels were higher in the AOP group. The use of systemic and biological treatments was significantly higher in COP patients, with earlier initiation of biological treatments.

Conclusions: The prevalence and age of onset of MetS were similar in COP and AOP patients. The onset age of obesity was earlier in COP patients, emphasizing the importance of weight management in pediatric psoriasis. Early and aggressive treatment targeting systemic inflammation may improve long-term outcomes by reducing comorbidities in psoriatic patients. This study highlights the need for a comprehensive treatment approach addressing both skin symptoms and associated systemic conditions.

Dermatitis herpetiformis (DH) is the specific cutaneous manifestation of celiac disease (CD), both of which require lifelong management. A comprehensive literature review was conducted to gather evidence on gender-related differences aiming at reducing healthcare inequalities. While women tend to be more symptomatic, the diagnosis is often delayed, leading to a reduced quality of life and an increased risk of long-term complications. This may be partly a consequence of the fact that they are more likely to present with seronegative forms. Moreover, in women, reproductive issues, known to be associated with DH and CD, along with osteopenia/osteoporosis, and anemia are particularly prevalent. It should be also noted that beyond personal diagnosis, DH and CD also affect women indirectly, as they often take on caregiving roles for affected family members. The lifelong adherence to a gluten-free diet, the only effective treatment for DH, imposes a substantial lifestyle and financial burden. Gluten-free diet is frequently perceived as both gendered and class-based, placing a disproportionate strain on women and lower-income households. In this regard, recent recommendations to prioritize naturally gluten-free foods rather than "gluten-free" products, may offer some relief. However, the responsibility for acquiring the skills necessary for such dietary choices often falls predominantly on women.