Journals
2015 EN
Andrea Diociaiuti · Alessandro Inserra · Irene Fuertes
+7 more
© 2015 The Authors. doi: 10.2340/00015555-1892 Journal Compilation © 2015 Acta Dermato-Venereologica. ISSN 0001-5555 Naevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is a rare, autosomal dominant disorder with systemic involvement (1). It is caused by germline mutations in the PTCH1 gene (locus 9q22.3– q31), which produce a tumour suppressor protein (2). The prevalence of NBCCS varies from 1/30,000 to 1/256,000 (3), depending on the geographic location. NBCCS is characterised by multiple basal cell carcinomas (BCCs) which usually develop at a young age, palmar or plantar pits, odontogenic keratocysts that appear in the first, second and third decades (4) of life and ectopic calcification of the falx cerebri. However, many other anomalies, such as macrocephaly, hypertelorism, cleft lip and/or palate, skeletal and eye abnormalities have been described in patients with NBCCS. Several low-frequency neoplasms, such as medulloblastoma, meningioma, ovarian and cardiac fibroma have also been reported in these patients. The diagnosis of NBCCS is based on clinical findings and familial history of the patient and can be made if 2 major and 2 minor criteria are met (4). Genetic counselling must be considered (3). Furthermore, during pregnancy, ultrasound scans can be performed to detect developmental malformations. Patients with NBCCS usually present to a dermatologist because of skin lesions; however, in addition to a periodic dermatological evaluation, management of the disease may require a wide range of specialists such as dentists, cardiologists, oncologists, and orthopaedic surgeons.
Soc for Publication of Acta Dermato-Venereologica
Journals
2015 EN
Alexander Börve · Johan Dahlén Gyllencreutz · Karin Terstappen
+6 more
In this open, controlled, multicentre and prospective observational study, smartphone teledermoscopy referrals were sent from 20 primary healthcare centres to 2 dermatology departments for triage of skin lesions of concern using a smartphone application and a compatible digital dermoscope. The outcome for 816 patients referred via smartphone teledermoscopy was compared with 746 patients referred via the traditional paper-based system. When surgical treatment was required, the waiting time was significantly shorter using teledermoscopy for patients with melanoma, melanoma in situ, squamous cell carcinoma, squamous cell carcinoma in situ and basal cell carcinoma. Triage decisions were also more reliable with teledermoscopy and over 40% of the teledermoscopy patients could potentially have avoided face-to-face visits. Only 4 teledermoscopy referrals (0.4%) had to be excluded due to poor image quality. Smartphone teledermoscopy referrals allow for faster and more efficient management of patients with skin cancer as compared to traditional paper referrals.
Soc for Publication of Acta Dermato-Venereologica
Journals
2015 EN
Klaus F. Kofoed · Christiorrbom · Ola Forslund
+10 more
Risk of human papillomavirus (HPV) transmission during laser vaporisation of genital warts or loop electrode excision procedure is controversial. An oral rinse, a nasal swabs, history of HPV related diseases and data on HPV exposure were collected from 287 employees at departments of dermato-venerology and gynaecology in Denmark. A mucosal HPV type was found among 5.8% of employees with experience of laser treatment of genital warts as compared to 1.7% of those with no experience (p = 0.12). HPV prevalence was not higher in employees participating in electrosurgical treatment or cryotherapy of genital warts, or loop electrode excision procedure compared with those who did not. HPV 6 or 11 were not detected in any samples. Hand warts after the age of 24 years was more common among dermatology than among non-dermatology personnel (18% vs. 8.0%, p = 0.03). Mucosal HPV types are infrequent in the oral and nasal cavity of health care personnel, however, employees at departments of dermato-venereology are at risk of acquiring hand warts.
Soc for Publication of Acta Dermato-Venereologica
Journals
2015 EN
Maria Estela MartínezEscala · Laia CurtoBarredo · Ll. Carnero
+2 more
Cold contact urticaria is the second most common subtype of physical urticaria. Cold stimulation standardized tests are mandatory to confirm the diagnosis. The aim of this study is to define the utility of determining thresholds (critical time and temperature) in assessment of the clinical course of typical acquired cold contact urticaria. Nineteen adult patients (10 women and 9 men; mean age 45 years) were included in the study and the diagnosis was confirmed with the ice-cube test and TempTest 3.0. Patients were treated continuously for 1 year with 20 mg/day rupatadine (anti-H1). Thresholds measurements were made before and after treatment. Improvements in temperature and critical time thresholds were found in the study sample, demonstrating the efficacy of continuous treatment with rupatadine. In most cases association with a clinical improvement was found. We propose an algorithm for the management of acquired cold contact urticaria based on these results.
Soc for Publication of Acta Dermato-Venereologica
Journals
2015 EN
Alessandro Borghi · Monica Corazza · Alberto Maria Bertoldi
+2 more
The efficacy and safety of acitretin was evaluated retrospectively in a cohort of 46 patients with moderate to severe plaque psoriasis (Psoriasis Area and Severity Index (PASI) range 10-42). Patients were treated at an initial dose of 10 mg/day acitretin, which was then gradually increased until the best therapeutic effect with the fewest adverse effects was reached (< 50 mg/day) and later decreased and maintained at the lowest effective dosage. Efficacy measures were: (i) PASI75 (75% improvement) and PASI50 between 10 and 16 weeks; and (ii) PASI75 even after 16 weeks of treatment. At weeks 10-16, PASI75 and PASI50 were achieved by 47.8% and 87% of the patients, respectively. Overall, 67.3% reached PASI75. Adverse events occurred in 18 patients (39.1%); among these, 4 (8.7%) discontinued acitretin. Our findings suggest that acitretin at an initial low, gradually escalating dose, and subsequently maintained at the minimal effective dose, is a suitable treatment option for plaque psoriasis as it provides clear-cut improvement in most treated patients while minimizing the risks of side-effects.
Soc for Publication of Acta Dermato-Venereologica
Journals
2015 EN
Felipe Maurício Soeiro Sampaio · Maria Clara Gutierrez Galhardo · Rodrigo De Farias Cardoso
+3 more
Mycetoma is a chronic, subcutaneous infection caused by traumatic inoculation through the skin of some types of filamentous aerobic bacteria (actinomycetoma) and true fungi (eumycetoma) (1, 2). It is considered a neglected disease with high morbidity and major effects on the patient’s quality of life (1–3). Few published cases have examined mycetoma during pregnancy (4–7). We report here a case of a patient with eumycetoma on her foot that exhibited significant clinical worsening during pregnancy, which illustrates the difficulty of treatment of this infection during pregnancy, when consideration of the teratogenic and toxic effects of antifungal drugs is paramount.
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Journals
2015 EN
F Cammisuli · Vito Emanuele Catania · Maria Rita Nasca
+2 more
Acta Derm Venereol 95 © 2015 The Authors. doi: 10.2340/00015555-2007 Journal Compilation © 2015 Acta Dermato-Venereologica. ISSN 0001-5555 A 55-year-old Caucasian farmer presented with a 1-year history of a slowly enlarging nodule on his right leg. His family history and past medical history was unremarkable. The patient believed that the lesion had been caused by accidental penetration of a foreign body into the skin. At onset, the lesion was very small and painless, but later on its size increased and it became painful. Symptoms were unresponsive to non-steroidal anti-inflammatory drugs. At physical examination, a raised reddish, mobile multinodular plaque, with irregular borders, of about 1 cm in diameter, with a small crust surrounded by a whitish scale, was evident on the anterior surface of the leg (Fig. 1). Blood tests, also including tumour markers, were negative. The lesion was surgically excised and examined histologically (Fig. 2). The lesion extended beyond the resection margins. Immunohistochemistry was positive for Desmin, Smooth Muscle Actin (SMA), and H-Caldesmon, and negative for S-100 protein, CD34, and cytokeratins.
Soc for Publication of Acta Dermato-Venereologica
Journals
2015 EN
Stefano Veraldi · Anna Grancini · Luigia Venegoni
+5 more
Aspergillus nidulans is a common soil saprophyte with a worldwide distribution. It was first isolated and described in 1906 by Nicolle & Pinoy in a Tunisian patient with mycetoma. Since then, only 4 cases of mycetoma have been published (1–5). We describe here a case of A. nidulans mycetoma in which, for the first time, mycological and histopathological examinations were confirmed by molecular identification.
Soc for Publication of Acta Dermato-Venereologica
Journals
2015 EN
Giuseppe Lombardo · Maria Pilla · Roberto Benucci
+6 more
Epidermolysis bullosa acquisita (EBA) is a rare acquired subepithelial blistering disease of the skin and mucous membranes associated with autoantibodies against type VII collagen (1, 2). Two main clinical variants are recognized: a classic mechanobullous and an inflammatory type (1, 2). Inflammatory EBA mimics other autoimmune bullous diseases and has at least 4 different clinical presentations: bullous pemphigoid (BP)-like EBA, mucous membrane pemphigoid (MMP)-like EBA, Brunsting-Perry pemphigoid-like EBA and linear IgA bullous dermatosis-like EBA (1, 2). Clinical features, histopathological or immunofluorescence studies are necessary to identify EBA, but they are not sufficient to confirm the diagnosis (1, 2). For a long time direct immunoelectron microscopy has represented the gold standard for EBA diagnosis (2). However, nowadays other methods such as u-serrated pattern analysis by direct immunofluorescence (DIF) microscopy (3), together with detection of circulating autoantibodies to type VII collagen by enzyme-linked immunosorbent assay (ELISA) or immunoblotting (IB) (4), are most frequently used due to their easier availability and feasibility. EBA has frequently been found in association with systemic diseases, in particular inflammatory bowel disease and systemic lupus erythematosus, but also rheumatoid arthritis, amyloidosis, diabetes mellitus, thyroiditis and other endocrinopathies (1, 2). Association with haematological diseases and solid tumours has also been described (5–14). We report here a case of BP-like inflammatory EBA in which search for an associated disease, prompted by treatment resistance, disclosed an underlying thyroid papillary carcinoma.
Soc for Publication of Acta Dermato-Venereologica
Journals
2015 EN
Maria Claudia Carvas Passarelli Tirico · Cyro Festa Neto · Neusa Yuriko Sakai Valente
+1 more
Although the injection of paraffin, mineral oil, and silicon into body parts began to be described in the 19th century, similar procedures had been practiced before that time (1). Women undergo wrinkle correction and breast augmentation, whereas men seek to achieve erectile enhancement and penile enlargement (2–5). Reports on the development of subcutaneous nodules at the sites of injection abound – commonly referred to as sclerosing lipogranuloma (SL) and paraffinoma (6). SL and paraffinoma are types of foreign body panniculitis that are characterized histopathologically by fat globules that vary in size, replacing subcutaneous fat tissue. These bodies are surrounded by multinucleated foreign body giant cells and are associated with chronic granulomatous inflammatory reactions, free fat droplets, hyalinization of fibrous tissue, fibrosis; calcification can occur in long lasting lesions (6). Visceral lesions of LG are rare and can lead to death (7, 8). We report an unusual case of SL with widespread cutaneous lesions and pulmonary compromise.
Soc for Publication of Acta Dermato-Venereologica