39 research outputs found
Dermatitis Artefacta in a Patient Affected by Impulse Control Disorder: Case Report
No full textDermatitis artefacta is a disease characterized by self-inflicted skin lesions in fully aware patients. Mechanical and chemical devices are most commonly used to produce such injuries. Several psychological disorders like depression, obsessive compulsive disorders, hysteria, etc. are associated with this kind of disease. Most of the patients are young females aged between 15 and 30, but the diagnosis of dermatitis artefacta may even be made in pediatric patients or elderly people. Because of its rarity and the polymorphism of lesions, dermatitis artefacta is often a challenge for the clinicians. More difficulties might be due to the lack of cooperation in these patients, who usually refuse the dialogue with doctors and deny their primary role in damaging their skin. We present a case of an elderly woman who showed a peculiar pattern of deep excoriating lesions disseminated on the upper part of her body, with an evident state of depression. Diagnostic and therapeutic procedure, that is often long lasting and difficult in such cases, was made by teamwork of dermatologists, psychiatrists and psychologists, leading to steady control of impulses and full remission of cutaneous symptoms
REAZIONI AVVERSE CUTANEE DEGLI INIBITORI DEL RECETTORE DELL’EPIDERMAL GROWTH FACTOR (EGFR): DESCRIZIONE DI UN CASO E REVISIONE DELLA LETTERATURA
No full textGli inibitori del recettore dell’epidermal growth factor
(EGFRs) sono associati a peculiari e severe reazioni
dermatologiche avverse. Cetuximab, gentifib e soprattutto
erlotinib sono farmaci utilizzati nel trattamento
di pazienti affetti da carcinoma del colon-retto e nel
non small cell carcinoma (NSCC) del polmone, refrattari
o intolleranti alla chemioterapia convenzionale.
Descriviamo il caso di un paziente caucasico di 46
anni, affetto da carcinoma NSC del polmone
(T3N2M0) in terapia da circa 8 mesi con erlotinib, che
presentava lesioni acneiformi diffuse su viso, tronco,
arti superiori e inferiori e paronichia. Il paziente veniva
trattato con macrolidi sistemici e steroidi topici con
miglioramento del quadro clinico. L’evento avverso
cutaneo secondario a trattamento con gli EGFRs più
frequentemente osservato è un’eruzione il cui quadro
istologico è caratterizzato da una pustola follicolare
sterile. Generalmente non è richiesta la sospensione
della chemioterapia ma spesso viene pregiudicata la
vita di relazione di tali pazienti. Sebbene il preciso
meccanismo etiopatogenetico di questa manifestazione
non sia ben definito, esso è correlato all’inibizione
dell’EGFR nella cute e può essere considerato un marker
visibile dell’attività anti-tumorale e dell’efficacia terapeutica
di tale classe di farmaci. È necessario individuare
schemi terapeutici mirati per il trattamento della
sintomatologia cutanea al fine di migliorare la qualità
di vita di tali pazienti
A curious case of opticneuritis in hidradenitis suppurativa patient, successfullytreated with adalimumab
No full textBackground: Hidradenitis suppurativa (HS), also known as acne inversa,
is a chronic inflammatory skin disease characterized by painful,
deep-seated
inflammatory nodules and abscesses appearing in
intertriginous regions of the body.
Objectives, Methods, Results and Conclusion: HS is associated
with other systemic inflammatory or autoimmune diseases, such as
Crohn’s disease, spondyloarthropathy, and Adamantiades-Behcet’s
disease. Recent case reports have documented the coexistence of
HS and inflammatory eye disease (IED), probably due to a common
immune dysregulation phenomenon. We present a case of optic
neuritis in HS patient, successfully treated with Adalimumab
Postacne scarring. Which factors are involved?
No full textPost acne scars are a frequent late complication of the disease. The factors that underlie their clinical heterogeneity and severity have not yet been clarified.2 The studies conducted on this topic are few and dated.2,3 Post acne scars can be particularly devastating and may even trigger suicidal ideation.4 Depending on tissue response to inflammation we can define two general types of acne scars: hypertrophic scars caused by increased tissue formation and atrophic scars caused by the loss of tissue. Both types of acne scars can be divided in 4 grades according to Goodman and Baron qualitative grading system
Adult acne versus adolescent acne. A rtrospective study of 1,167 patients
No full textBackground: Acne is predominantly known as a skin disorder of the adolescent population. However, current research indicates that the prevalence of adult patients with acne, especially among women, is increasing. Objective: The objective of this study was to evaluate differences between adults and teenagers with regard to acne prevalence, patient sex, acne severity, and quality of life. In adult patients, we considered differences in family history of acne, onset, and smoking habits. Design: We performed a retrospective study of a total of 1,167 patients with acne who attended our outpatient clinic from January 2008 to March 2015. Participants: The study population was divided into two groups: adolescent acne and adult acne. Among the adult subjects, 385 were female and 69 were male; among the adolescent subjects, 378 were female and 335 were male. Measurements: The severity of acne was recorded using the Global Acne Grading System. The impact of acne on quality of life was investigated using the Assessment of Quality of Life questionnaire. Results: Study results show that acne in female patients was more prevalent than in male patients. The evaluation of acne severity showed that "mild acne" is the most frequent form. With regard to smoking habits, time of onset, and family history of acne, we did not find any statistically significant differences between the sexes. Conclusion: In both sexes, there are some differences in adult acne versus the adolescent form. Treating adult acne demands a different approach to diagnosis and a tailored management plan that considers all of the variables involved
Herpes zoster ophthalmicus in two women after Pfizer-BioNTech (BNT162b2) vaccine
No full textVaricella‐zostervirus(VZV) isresponsibleforaprimaryinfection (i.e., chickenpox); subsequently, thevirus remains dormant at the level of thespinal dorsal root andcranial ganglia. Inconditionsof stressor immunosuppression, itcanreactivateandcausesecondary herpes zoster (HZ) infection. HZOaccounts for 10%–20%ofHZ casesandischaracterizedbyinvolvementoftheophthalmicbranch ofthefifthcranialnerve. It isconsideredadangerousconditionthat couldleadtosevereconsequencessuchasblindnessin20%–70%of thecases.3Themainriskfactors for thereactivationofVZVarea compromiseofthecell‐mediatedimmunity(CMI)thatpresentsitself inoldage, insomechronicdiseasessuchasdiabetes, autoimmune disease,HIV,andduringimmunosuppressivetherapies.4 Several casesofHZhavebeendescribed inPfizervaccinerecipients,however,onlyoneofthemwithophthalmiclocalization, ina 56‐year‐oldwomanwithrheumatoidarthritis.5 Wereport twocasesofpostvaccineHZOalthoughararelyreportedadverseeventwithpotentiallyseriousconsequences. HZOwasalsodiagnosedinfourpatientssufferingfromamoderateformofCOVID‐19infection6thatwereeffectivelytreatedwith antiviralswithoutanyvisual sequelae. Inthesecases, thetriggering factorforviralreactivationisprobablyduetolymphopeniasecondary to SARS‐CoV‐2
PSSD and biologic therapy: real-life data in 417 patients with moderate to severe psoriasis
No full textBackground: Psoriasis is a chronic relapsing immune-mediated disease leading to a strong impact on patient's quality of life. The treatment of psoriasis has undergone a revolution with the advent of biological therapies. Currently, Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores are in use to assess the overall severity of pathology. A new self-administered questionnaire, the Psoriasis Symptoms and Signs Diary (PSSD), assesses the severity of six psoriasis symptoms (itch, skin tightness, burning, stinging, and pain,) and five signs (dryness, cracking, scaling, shedding/flaking, redness, and bleeding). Objective: To evaluate and compare the efficacy of biologic therapies through PSSD in patients with moderate to severe psoriasis. Methods: The PSSD questionnaire was administered to all the patients at the beginning and after 6 months of biologic therapy (anti-TNFalpha, anti-IL17, anti-IL23, anti-IL12/23 and phhosphodiesterase-4 Inhibitors). Results: The study population included 417 adult patients with moderate to severe psoriasis in treatment with biologic drugs. All the drugs contributed to a significant improvement in mean total PSSD at t 24; anti-IL17 and anti-IL23 led to a significantly greater reduction at t 24 mean PSSD when compared to other therapies. Conclusion: The PSSD, is a new validated instrument useful for capturing psoriasis patient's quality of life and evaluating treatment efficacy. In our study, this score has been useful to put in evidence significant differences between biological drugs
Aesthetic treatments in cancer patients
No full textCancer patients are experiencing an increase in overall survival as a consequence of earlier diagnosis and newer effective anticancer therapies. However, cancer survivors often face long-term consequences from their original cancer diagnosis and long-term sequelae of anticancer treatment. Maintaining patients' quality of life is of paramount importance and this can be accomplished by a multidisciplinary treatment approach, including aesthetic treatments to improve patients' body image and positively impact their quality of life. In this perspective, we will discuss the importance of aesthetic treatments in cancer patients. In addition, we will summarise the data available regarding the use of several aesthetic treatments such as fillers, botulinum toxin and laser use in cancer patients, their safety, their efficacy, and the specific precautions that need to be implemented in this particular subset of cancer patients
