Italian Journal of Dermatology and Venereology最新文献

Background: Lichen planopilaris (LPP) and pseudopelade of Brocq (PPB) are lymphocytic scarring alopecias that commonly involve the scalp with alopecic patches and can be considered as a unique nosologic condition. The medical features of patients affected by scalp Lichen planopilaris were reviewed to identify demographic differences between the classic LPP (C-LPP) and the pseudopelade of Brocq variant (PB-LPP).

Methods: A retrospective analysis of patients with classic Lichen planopilaris (C-LPP) and the pseudopelade of Brocq variant (PB-LPP) was conducted. Demographic and clinical data, results of trichoscopy and histopathology were analyzed.

Results: Sixty patients with LPP were followed up from March 2020 to March 2023. The mean age of the population at the time of the analysis was 63.1 years, and the mean age at clinical or histological diagnosis of LPP was 60.1. The predominant sex was female. The clinical-histological diagnosis of PB-LPP was reported in four patients (6.7%), the remaining presented a variant of C-LPP. No significant differences between the two variants of LPP concerning mean patient age and age at diagnosis was found. PB-LPP was more frequent in the male gender than in the female gender. No difference was observed for concomitant autoimmune diseases.

Conclusions: Our study confirms a prevalence of classic Lichen planopilaris in female patients and a predilection for the pseudopelade of Brocq LPP in the male patients. However, due to the low number of cases due to rarity of diseases, more studies are needed to confirm our data and hypotheses.

Background: Pigmented purpuric dermatoses (PPD) are a group of chronic, benign skin conditions with limited evidence-based data regarding their diagnosis and management. The aim of our work was to evaluate the clinical practices of dermatologists in managing PPD, focusing on patient presentation, treatment preferences, and the need for further diagnostic evaluations.

Methods: We utilized a survey-based design for the present study. The survey was distributed to the Study Group on Cutaneous Vascular Diseases and Skin Ulcers of the Italian Society of Dermatology and Venereology. The survey collected data on the number of patients evaluated weekly, the proportion of patients requesting treatment, preferred therapeutic approaches, and indications for additional diagnostic tests.

Results: Twenty-four clinicians from 11 centers participated. Respondents reported managing an average of 5 PPD cases per week, with treatment required in approximately 50% of cases, while the remainder were incidental findings during evaluations for other dermatological conditions. Skin moisturizers and topical corticosteroids (tCS) were universally recommended as first-line treatments. Additional therapies included zinc oxide cream, compression stockings, and flavonoid-based oral supplements. Further diagnostic workups, such as leg Doppler ultrasound, skin biopsy, and blood tests, were considered necessary only in selected patients based on clinical presentation and comorbidities.

Conclusions: Moisturizers and tCS are the cornerstone of PPD treatment, supplemented by tailored therapies and diagnostic evaluations. These findings highlight the need for standardized, evidence-based guidelines to optimize the management of PPD.

Background: Several studies have explored the potential association between lichen planus (LP) and chronic hepatitis C (HCV) and hepatitis B virus (HBV) related, yielding conflicting results.

Objective: To determine whether there is an association between these two entities, through a systemic review and meta-analysis.

Methods: Bibliographic searches were conducted using PubMed and Scopus databases. Data obtained from papers included in the systematic review were put into a quantitative meta-analysis, carried out with SPSS software version (29.0.2.0).

Results: Out of the initial pool of 834 studies, 45 studies met the inclusion criteria for meta-analysis. The odds ratio (OR) for HCV-seropositivity in LP patients was 4.55 (95% CI, 3.08-6.74), with higher ORs observed in Mediterranean basin countries (OR: 5.41, 95% CI: 3.16-9.29). In Italy, the OR was 4.42 (95% CI, 1.99-9.81). A regional variation was noted within Italy, with a higher OR in northern Italy-compared to southern Italy. Similar associations were found in Asian countries, with an OR of 4.49 (95% CI, 2.94-6.88). However, in northern Europe, the pooled OR was 0.733 (95% CI, 0.15-3.66), indicating no statistically significant association. When considering subjects with HCV infection, the presence of LP showed a pooled OR of 3.22 (95% CI, 1-10.34). Regarding HBV infection, the OR was 1.51 (95% CI, 1.15-1.97), with no differences and was similar when analyzing different subgroups.

Conclusions: Our study indicates a moderate to high risk for HCV in patients with LP, according to geographic region, while the risk remains uncertain for HBV with respective ORs of 4.55 (95% CI, 3.08-6.74) and 1.51 (95% CI, 1.15-1.97). It seems reasonable to test the sera of patients affected by LP for anti-HCV antibodies, while the necessity of testing for HBV remains more uncertain.