1,720,991 research outputs found
La terapia oncologica: i suoi effetti collaterali su cute e annessi. Come gestirli
No full textLa lotta condotta dalla comunità scientifica contro la malattia del secolo ha ridotto notevolmente la mortalità dei pazienti affetti da cancro. Un traguardo raggiunto grazie al miglioramento della diagnosi precoce e all’adozione di innovativi protocolli terapeutici. L’aumentata sopravvivenza
al cancro, spesso, non si accompagna ad una soddisfacente qualità della vita: da qui la necessità di passare dal concetto abbastanza riduttivo di “cura del paziente” a quello di “prendersi cura del paziente”, adottando una visione olistica della malattia e degli effetti collaterali della terapia sul
corpo e sulla psiche. Lungo questo percorso, l’impiego di un team multidisciplinare, composto da figure professionali con competenze specifiche nella gestione di questi pazienti, diventa un punto focale per ottenere maggiori benefici attraverso percorsi assistenziali diagnostici-terapeutici, che si prendono cura del malato in tutte le fasi della patologia, migliorando la risposta ai trattamenti e favorendo il tempestivo accesso a terapie riabilitative e di supporto per un’efficace gestione del paziente
Tricoscopia. Le basi per la diagnosi delle malattie dei capelli e del cuoio capelluto
No full textLe metodiche non invasive in dermatologia, come in medicina, rappresentano una scienza in perenne evoluzione, le nuove acquisizione e un'esperienza clinica approfondita hanno permesso negli ultimi anni di effettuare diagnosi sempre più mirate senza la necessità di ricorrere a tecniche invasive. La tricoscopia si pone all'avanguardia per la diagnosi non invasiva delle patologie del capello e del cuoio capelluto. L'atlante nasce per fornire i mezzi clinici-diagnostici a chi si avvicina a questa branca per orientarsi in maniera pratica nella gestione dei pazienti affetti da alopecie. Gli argomenti saranno trattati metodicamente attraverso descrizioni grafiche e iconografiche derivanti dall'esperienza acquisita nella tricoscopia dall'inizio del suo impiego a oggi
Multi-therapies in androgenetic alopecia: review and clinical experiences.
Full text linkAndrogenetic alopecia (AGA) is a genetically determined progressive hair-loss condition
which represents the most common cause of hair loss in men. The use of the medical term
androgenetic alopecia reflects current knowledge about the important role of androgens and genetic
factors in its etiology. In addition to androgen-dependent changes in the hair cycle, sustained
microscopic follicular inflammation contributes to its onset. Furthermore, Prostaglandins have been
demonstrated to have the ability in modulating hair follicle cycle; in particular, PGD2 inhibits hair
growth while PGE2/F2a promote growth. Due to the progressive nature of AGA, the treatment should
be started early and continued indefinitely, since the benefit will not be maintained upon ceasing
therapy. To date, only two therapeutic agents have been approved by the Food and Drug
Administration and European Medicines Agency for the treatment of AGA: topical minoxidil and oral
finasteride. Considering the many pathogenetic mechanisms involved in AGA, various treatment
options are available: topical and systemic drugs may be used and the choice depends on various
factors including grading of AGA, patients’ pathological conditions, practicability, costs and risks. So,
the treatment for AGA should be based on personalized therapy and targeted at the different
pathophysiological aspects of AG
A preliminary study on topical cetirizine in the therapeutic management of androgenetic alopecia.
No full textAndrogenetic alopecia (AGA) is a common form of scalp hair loss that affects up to 50% of males between 18-40 years old. Several molecules are commonly used for the treatment of AGA, acting on different steps of its pathogenesis (Minoxidil, Finasteride, Serenoa repens) and show some side effects. In literature, on the basis of hypertrichosis observed in patients treated with analogues of prostaglandin PGF2α , was supposed that prostaglandins would have an important role in the hair growth: PGE and PGF2α play a positive role, while PGD2 a negative one. We carried out a pilot study to evaluate the efficacy of topical cetirizine versus placebo in patients with androgenetic alopecia. We found that the main effect of cetirizine was an increase of total hair density, terminal hair density and diameter variation from T0 to T1, while the vellus hair density shown an evident decrease. The use of a molecule as cetirizine, with no notable side effects, make possible a good compliance by patients. Our results have shown that topical cetirizine 1% is responsible for a significant improvement of the initial framework of androgenetic alopecia
A case of Scalp Rosacea treated with low dose doxycycline and probiotic therapy and literature review on therapeutic options
Full text linkRosacea is a common chronic inflammatory disorder showing a wide range of clinical features such as telangiectasia, erythema, papules, and pustules primarily involving the central part of face (forehead, cheeks and nose) although extra facial manifestation have been described. We describe a case of rosacea with predominant scalp involvement successfully treated with a 8-week-course of doxycycline 40 mg once a day and probiotic therapy twice a day (Bifidobacterium breve BR03, Lactobacillus salivarius LS01 1 × 10(9) UFC/dose)
Chemotherapy-induced alopecia management: Clinical experience and practical advice
Full text linkBackground:
Chemotherapy-induced alopecia (CIA) is probably one of the most
shocking aspects for oncological patients and underestimated by physicians. Among
hair loss risk factors, there are treatment-related aspects such as drug dose, admin-
istration regimen, and exposure to X-rays, but also patient-related characteristics. To
the best of our knowledge, no guidelines are available about CIA management.
Aims and methods:
With this study, based on literature background and our clinical
experience, we would like to propose a list of actions in order to estimate the risk
of hair loss before starting chemotherapy and to manage this condition before, dur-
ing, and after drug administration and to create a sort of practical guide for derma-
tologists and oncologists.
Results and conclusion:
There is an urgent need for prospective studies to clarify
the mechanistic basis of alopecia associated with these drugs and consequently to
design evidence-based management strategies
Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up
No full textFinasteride 1 mg is indicated for the treatment of men with androgenetic alopecia (AGA). However, more than 5 years efficacy and safety has not been previously reported. To assess the efficacy over 10 years in different age groups of men with AGA. 118 men, between 20 and 61 years, with AGA receiving finasteride (1 mg/day), were enrolled in this uncontrolled study. Efficacy evaluation was assessed with standardized global photographs at T0, T1, T2, T5, T10. Statistical analysis was made using frequency tables and evaluating the chi-square index with its p-value. Better improvements are observed in patients older than 30 years (42.8% aged between 20 and 30 years did not improve also after 10 years) or with higher AGA grades (58.9% for AGA grade IV and 45.4% for AGA grade V had the first improvement just after 1 year). In 21% of cases, the treatment continuation beyond 5 years provided better results. Side effects were referred by 6% of the patients; nevertheless, some of them went on with treatment because of the great results. In our opinion, the result after the first year can help in predicting the effectiveness of the treatment. Its efficacy was not reduced as time goes on; in fact, a big proportion of subjects unchanged after 1 year, improved later on, maintaining a positive trend
Clinical, Histological and Trichoscopic Correlations in Scalp Disorders
Full text linkTrichoscopy is the term coined for the dermoscopic imaging of scalp and hair. This diagnostic technique, simple and noninvasive, can be used as a handy bedside tool for the diagnosis and follow-up of hair and scalp disorders. It allows the recognition of morphologic structures not visible by the naked eye and provides the clinician with a range of dermoscopic findings necessary for differential diagnosis. Trichoscopy observation can be broadly grouped as interfollicular patterns and follicular patterns. Recently, a third mixed class, called the follicular plus interfollicular pattern, has been introduced. Some of these features are specific to a certain scalp disease, while others can be found in many hair disorders. Although studies suggest that the use of trichoscopy can improve clinical accuracy, further investigation is needed. This review provides update information on the trichoscopic features of the most common scalp disorders, striving to show a histopathological and clinical correlation
Use of topical ephedrine and naphazoline in the treatment of a keratoacanthoma: two case reports.
No full textKeratoacanthoma(KA) is a relatively common low-grade malignant keratinocytic neoplasm, usually involving sun exposed areas. Up to date the etiopathogenesis of KA is not completely understood, although it is assumed that the lesion is derived from the hair follicle and that several chemical and non-chemical factors(as chemical carcinogens, mineral oil, cigarettes, trauma and immunosuppres-sion) may be implicated [1,2].
KA presents three distinct stages, characterized in a rapid proliferative phase(6-8 weeks) [3,4], a phase of stop growing [5,6] and a third stage (or involution stage) where 50% of KA undergo to spontaneous resolution in 4–6 weeks, leaving an atrophic and hypopigmented scar [7].
The typical clinical specificity and natural course of the lesion, in some cases does not require a surgical treatment and histological examination, favoring a non-invasive treatment of the lesion
Isochemotopic response: the first case on a scar
No full textA 65-year-old male patient affected by adenocarcinoma of the lung received systemic chemotherapy. The regimen chosen by the oncologists was an association of both classic chemoterapeutic drugs and target therapy, specifically cisplatin, paclitaxel and pembrolizumab. Fifty-three years prior, the patient had underwent surgery for a non-specified thyroid carcinoma and, as a consequence of this, had a scar in the anterior region of the neck. The patient’s history was also positive for type 2 diabetes, in treatment with metformin, and a precedent cholecystectomy. During the third infusion of the expected chemotherapeutic protocol, the patient developed an acute inflammatory reaction upon the scar area. Upon clinical examination, it appeared erythematous, edematous and there was a mild temperature increase and an increased stiffness detectable upon palpation. The patient also complained of mild discomfort and referred that the last therapeutic cycle had been associated with weakness, diarrhea and fever that had resolved spontaneously within 24 hours from the infusion. Routine blood analysis were normal. Considering the history, there was a clear link between the therapy and the reaction. We defined this as “isochemotopic”
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