Italian Journal of Dermatology and Venereology最新文献

Omalizumab is a humanized monoclonal IgG1 antibody approved by the US-FDA for the treatment of chronic spontaneous urticaria (CSU) unresponsive to H1-antihistamines. The aim of this review is to outline the utility of omalizumab in all types of urticarias, as well as other off-label dermatological disorders. A comprehensive literature search was conducted to identify studies evaluating the utility of omalizumab in dermatology. Databases searched included PubMed, Medline, and Embase. All original studies including case reports, case series and clinical trials were included if they were full-text, involved a dermatologic disorder treated with omalizumab and published in English. Articles were excluded if they were conference abstracts, non-clinical reports, or invitro studies. Apart from CSU, the efficacy of omalizumab has been demonstrated in atopic dermatitis (AD), bullous pemphigoid (BP), hyper IgE syndrome (HIES), mastocytosis, and Kimura's disease (KD), with the level of evidence varying for each disorder. Besides, in anecdotal reports, the benefits of omalizumab in TEN and Netherton Syndrome has been highlighted. Omalizumab offers a promising therapeutic option for a variety of dermatologic disorders beyond CSU. Further research is needed to optimize treatment protocols and establish definitive guidelines for omalizumab use in these conditions to facilitate quicker disease remission, improved safety, and reduced reliance on conventional immunosuppressants. However, the high cost of omalizumab remains a significant barrier for its widespread use in developing countries.

Introduction: Androgenetic alopecia (AGA), or pattern hair loss, is the most common form of hair loss worldwide. It is primarily caused by genetic and hormonal factors, particularly the action of dihydrotestosterone (DHT) on hair follicles.

Evidence acquisition: A comprehensive literature search on PubMed and Google Scholar was conducted until October 31, 2024, using keywords related to male AGA and its treatments. Relevant reviews, meta-analyses, clinical trials, and case studies in English were selected and analyzed to enhance the quality of the research. This review is based solely on existing studies and does not include new human or animal research conducted by the authors.

Evidence synthesis: This review thoroughly examined and analyzed 149 articles to provide a detailed presentation of the evidence.

Conclusions: This article examines both established and emerging therapies for AGA. We recommend initiating treatment with topical minoxidil and oral finasteride, as these are extensively researched and FDA-approved options for male AGA. For patients who do not respond well or cannot tolerate these treatments, clinicians may explore alternative therapies and approaches.

Malar bags are a common aesthetic concern characterized by swelling and puffiness in the prezygomatic space and cheek area. Various medical and surgical techniques have been developed to address this condition and restore a more youthful and rejuvenated appearance. In terms of medical therapies, non-invasive options such as topical creams containing retinoids, peptides, and hyaluronic acid have shown promise in reducing mild malar bags. These substances help improve skin texture, promote collagen production, and enhance skin elasticity, thereby reducing the appearance of swelling and puffiness. Additionally, injectable treatments such as dermal fillers have been utilized to camouflage malar bags and create a smoother contour. By strategically placing fillers in the surrounding areas, a skilled practitioner can achieve a more harmonious facial appearance. In recent years, advancements in radiofrequency have also shown promise for treating malar bags. Laser skin resurfacing procedures can help tighten the skin, stimulate collagen production, and reduce the appearance of swelling and wrinkles in the malar area. For patients seeking more lasting results, surgical techniques provide viable options. Blepharoplasty, a surgical procedure aimed at correcting eyelid issues, can be performed to remove excess skin and fat deposits in the lower eyelid, effectively addressing malar bags. Additionally, newer techniques like endoscopic surgery allow for minimal incisions and reduced scarring, making them appealing to patients concerned about visible postoperative marks. Although numerous medical and surgical techniques are available, the choice of treatment depends on factors such as the severity of the condition, patient preferences, and the expertise of the medical practitioner. In this manuscript we have made a retrospective evaluation of the medical and surgical therapies of malar bags and we report our considerations after 20 years of experience.

Gender medicine has been achieving increasing importance. Gender differences in disease depend on hormonal status and may involve functions of the skin, immune responses and metabolic pathways, and have to do also with indications and response to treatments. Psoriasis is a common chronic inflammatory immune-mediated disease. The prevalence of psoriasis in the population is balanced between males and females, but early onset psoriasis is slightly more prevalent in males, with the latter suffering from a more severe disease. In general, male and female patients receive identical drugs at equivalent dosages. However, females receive systemic treatments less frequently compared to males. Males are more satisfied with their psoriasis treatment and respond better to biologics. Females have a significant higher rate of adverse events and drug-related discontinuation rate compared to males. About conventional systemic treatments for psoriasis during pregnancy, only cyclosporine is suggested when the benefits exceed the potential side effects, whereas methotrexate is contraindicated during pregnancy and lactation and in the three months before fatherhood and motherhood. Among the biologics, only certolizumab pegol is considered safe in pregnant patients, as it does not cross the maternal-placental barrier. Therefore, it is important to consider a gender perspective in the treatment of psoriasis, including her willingness to procreate. This is a narrative review highlighting the challenges that the healthcare dermatologists may face regarding management of psoriasis in female patients.