Acta dermato-venereologica最新文献

Contact urticaria syndrome, encompassing immunological contact urticaria and protein contact dermatitis, comprises immediate cutaneous reactions with potential systemic manifestations, including anaphylaxis. These conditions are frequently underdiagnosed despite their significant occupational impact. This study aimed to evaluate the clinical and laboratory features associated with distinct phenotypes of contact urticaria syndrome. A retrospective, observational analysis was performed at Hospital del Mar (Barcelona) from January 2010 to January 2024, including adult patients diagnosed with immunological contact urticaria and/or protein contact dermatitis and a positive prick test. Demographic data, clinical data, and complementary test results, including culprit agents, were compared between patients with isolated contact urticaria and those with protein contact dermatitis. A total of 95 patients were included. Results indicated that isolated contact urticaria was more frequently associated with facial involvement (n = 19, 28.8%) and a higher rate of systemic reactions (n = 18, 27.3%), including anaphylaxis, whereas protein contact dermatitis was frequently occupational-related (n = 19, 65.5%), and with a trend toward higher atopic dermatitis comorbidity (n = 12, 41.4%). These findings emphasize the heterogeneity of contact urticaria syndrome and underscore the importance of comprehensive clinical evaluation for effective diagnosis and management.

Molluscum contagiosum (MC) is a common paediatric cutaneous infection caused by a DNA poxvirus, resulting in lesions that often impair patients' quality of life. Although MC typically resolves spontaneously, parents frequently seek treatment due to cosmetic concerns, pruritus, or fear of lesion spread. Currently, there is no gold standard treatment, and various therapeutic modalities - including curettage and electrodessication (ED) - are utilized in clinical practice. This prospective comparative study aimed to compare efficacy, cosmetic outcome, and patient satisfaction with curettage vs ED as treatment methods in the treatment of MC. The study included 103 paediatric patients presenting with confirmed MC and ≥ 10 lesions (or 5 on face), treated at Sheba Medical Center. Treatment allocation to either curettage or ED was based on guardian preference. Data collected included demographic and clinical characteristics, procedural outcomes, pain levels, and satisfaction ratings. Structured questionnaires were administered 6 weeks post-procedure to evaluate outcomes, including lesion recurrence, infection, remnants, healing duration, and patient/parent satisfaction. Statistical analyses were conducted, with statistical significance defined as p ≤ 0.05. Among the cohort (mean age, 4.37 years; 60% female), 67 (61.7%) patients were treated with curettage and 42 (38.3%) with ED. Most presented with facial lesions (67.96%) and multiple lesion sites (50.5%). Patients treated with curettage reported fewer remnants (42.9% vs 70%, p = 0.007), greater aesthetic satisfaction (p = 0.039), and faster recovery (p = 0.050). Pain levels were comparable between groups, but higher 1-week post-procedure in ED (p = 0.014). Recurrence rates were similar for both methods (49.2% curettage, 35% ED). Curettage offers clear advantages over ED for the treatment of MC, resulting in superior aesthetic outcomes, faster recovery, and lower post-procedural pain. Therefore, curettage should generally be preferred, while ED may be considered for precise interventions in sensitive anatomical areas.

Dupilumab, the first biologic treatment approved for moderate to severe atopic dermatitis, has completely revolutionized the management of such disease allowing long-term control of its clinical signs and symptoms. Nevertheless, data regarding the safety and effectiveness profile of dupilumab in patients belonging to special populations are scarce. This observational, multicentric study analysed the effectiveness and safety profile of dupilumab over 3 years in the treatment of 70 patients with moderate to severe atopic dermatitis and associated comorbidities such as cancers, renal and liver failure, viral chronic infections, and degenerative and autoimmune neurological disorders. Patients achieved a significant improvement in both physician-assessed and patient-reported outcomes after 16 weeks of treatment, with a continuous therapeutic response maintained throughout the 156-week period. The safety profile was comparable to clinical trials and real-world data involving patients without significant comorbidities. In conclusion, the findings support the safety of dupilumab in managing severe atopic dermatitis in fragile patients.

Cutaneous basal cell carcinoma (BCC) is a primarily indolent tumour that is easily cured. However, locally advanced BCC (laBCC) and metastatic BCC can have a poor prognosis. This retrospective cohort study, conducted at a single cancer centre over a 32-year period, reports the characteristics and clinical course of 51 patients with laBCC or metastatic BCC. Thirty-five patients were men (69%), with a mean age of 72 years. Most primary BCCs were located in the head and neck (59%), and were treated with surgery (78%). Thirty-four patients had laBCC; 6 of those developed subsequent metastasis. Twenty-three metastatic BCCs were included. The median size of laBCC was 73 mm (IQR 110; range 15-400 mm), with 71% measuring 5 cm or larger. Tumour infiltration beyond the subcutaneous fat was present in 59% of laBCC and bone infiltration in 12%. Of laBCC, 44% experienced local recurrence after resection, which was seen in 35% of local tumours later developing metastasis. Median time to metastasis was 33 months. Most patients developed nodal metastases only (70%), but 26% developed distant metastases. Fifteen patients died during follow-up (29%). Three patients died of their laBCC with a 5-year disease-specific survival of 79%. Five-year disease-specific survival for metastatic BCC was 30%. Patients with laBCC in this cohort were at high risk of local recurrence and metastasis, and 12% died of their laBCC. These findings highlight the need for intensified follow-up for this relatively rare population, especially since Hedgehog inhibitors and PD1 inhibitors might be available for these patients.