1,720,964 research outputs found
Advanced glycation end products (AGEs) in patients with chronic plaque psoriasis
No full textLa formazione dei prodotti terminali della glicazione delle proteine (AGEs) è aumentata in condizioni caratterizzate da iperglicemia, iperlipidemia e stress ossidativo, un profilo metabolico frequentemente riscontrato in pazienti affetti da psoriasi cronica in placche.È stato effettuato uno studio trasversale caso-controllo, in ambiente ospedaliero, che ha valutato l’accumulo cutaneo ed ematico degli AGEs, comprendente i livelli totali degli AGEs, di pentosidina, del recettore di superficie cellulare per gli AGEs (RAGE) e del recettore solubile (sRAGE) in pazienti affetti da psoriasi lieve, psoriasi grave, eczema grave e in individui sani.Lo studio ha dimostrato un aumento statisticamente significativo degli AGEs nei pazienti affetti da psoriasi e una correlazione diretta tra gravità della patologia e valore degli AGEs. L’incremento dei livelli cutanei degli AGEs è risultato, inoltre, direttamente correlato a quello dei livelli sierici in tutti i soggetti partecipanti.I risultati suggeriscono che la glicazione proteica avanzata abbia un ruolo rilevante nella patogenesi della psoriasi e che possa portare a un aumentato rischio di sviluppare disturbi metabolici ed eventi cardiovascolari in pazienti con psoriasi.Background: Psoriasis is a common chronic inflammatory immune mediated skin disease frequently associated with metabolic comorbidities. Advanced Glycation End Products (AGEs) are a group of highly oxidant, biological active compounds which tissue accumulation provokes structural alterations occurring mostly in conditions such as hyperglycemia, hyperlipedemia and oxidative stress, a metabolic profile frequently encountered in patients affected by psoriasis.Objectives: Investigate if psoriasis is associated with skin and serum AGEs accumulation, and evaluate the possible pathogenetic role of AGEs in linking psoriasis with metabolic disorders.Methods: This was a hospital-based cross-sectional case-control study including 80 patients with severe or mild psoriasis and 80 age, sex and body mass index matched controls (40 patients with severe eczema and 40 healthy individuals). Exclusion criteria were psoriatic arthritis, diabetes, dyslipidemia, hypercholesterolemia, hypertension, smoking habit or on-going treatment. Skin AGEs were measured in normal appearing skin of the forearm by a standard fluorescence technique. Blood AGEs levels, including total AGEs rate, total pentosidine, AGEs cellular receptor (RAGE) and soluble receptor (sRAGE) were measured by ELISA. Results: Cutaneous AGEs (P < .04), serum AGEs (P < .01) and pentosidine levels (P < .0001) were higher in patients with severe psoriasis compared to patients with mild psoriasis or severe eczema and healthy controls. Skin and serum AGEs levels well correlated in all subjects (r = 0.93, P < .0001). Cutaneous and serum AGEs highly correlated with the psoriasis area and severity score (r = 0.91, P < .0001). On the contrary, RAGE levels were lower (P < .001) in patients with severe psoriasis and inverse correlated with disease severity (r = -81, P < .0002). The sRAGE levels were significantly higher in patients with severe or mild psoriasis and in patients with severe eczema as compared to healthy individuals (P = .04, P = .007, P = .02 respectively).Conclusions: Patients with severe psoriasis have skin and serum accumulation of AGEs, independently from metabolic disorders. AGEs may be relevant to several aspects of psoriasis pathogenesis
Palmar filiform hyperkeratosis
No full textFiliform hyperkeratosis (FH) is a rare entity of unknown
etiology clinically characterized by keratotic digitations
located peripherally on palms and soles or centrally on
the trunk. In our patient, cutaneous lesions were regarded as a
clinical sign of the tumor, as she went into complete
remission after surgery to treat liver metastases. Therefore,
we consider palmar–plantar FH a form of paraneoplasia.
This case was presented both for the rarity of FH and
to alert physicians to these minimal cutaneous signs, as
they might be associated with malignancies or metastases
Sensitizing potential of triclosan and triclosan-based skin care products in patients with chronic eczema.
No full textDermatite atopica e sport
No full textl'articolo è relativo a uno studio di coorte in cui analizzano le relazioni tra attività sportiva e dermatita atopica
Erythema nodosum: etiological factors and relapses in a retrospective cohort study.
No full textErythema nodosum (EN) is a septal panniculitis which may be associated with a wide variety of factors and disorders. In some patients it is recurrent, but few studies have considered recurrent EN. Our aim was to describe the causes of and diseases associated with EN and relapsing EN. Patients diagnosed with EN from 1997 to 2007 were included. EN was defined as post-infective, based on temporal, clinical, laboratory and microbiological criteria. Diagnosis of drug-induced EN was based on a temporal correlation, on the relapse of EN after drug re-introduction and on the absence of relapsing EN with a continuous treatment with the imputed drug. When the above criteria were excluded and EN was not associated with an underlying systemic disease or pregnancy, it was considered idiopathic.124 patients (mean age 39.5 years; median 37 years; range 4-90 years) were visited and re-evaluated after one to ten years (mean ± SD follow up time 5 ± 4 years). In 73 (58.8%) patients an aetiology of the first manifestation of EN was attributed to infections (25.8% of the total number; 32% of those with an attributed aetiology), drugs (mostly sex hormones; 15.3%; 26%), systemic diseases (11.2%; 19.2%) and pregnancy (6.5%; 10.9%). EN relapsed in 33 (26.6%) patients and was mostly attributed to infections and drugs. Factors responsible for the first manifestation of EN frequently differed from those causing relapses in the same patients, with the exception of drug-induced EN. We conclude that drug-induced EN can recur after re-exposure to the same drug, and the recurrence can be predicted
Eruptive disseminated porokeratosis associated with internal malignancies: a case report
No full textCutaneous manifestations of adult-onset Still's disease: a case report and review of literature
No full textAdult onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology and pathogenesis characterized by high spiking fever, arthralgia or arthritis, sore throat, lymphadenopathy, hepatosplenomegaly, serositis, and transient cutaneous manifestations. Although more common in children, cases are seen also in adults. Cutaneous involvement is common and may be suggestive for the diagnosis. A case of AOSD in a 35-year-old man is reported here, presenting with urticarial maculopapular rash of trunk, high spiking fever, acute respiratory distress syndrome, and myopericarditis. Skin biopsy showed interstitial and perivascular mature CD15(+) neutrophils. A comprehensive review of literature showed that cutaneous involvement occurs in about 80 % of patients, with various clinical presentations. The most common skin manifestation is an evanescent salmon pink or erythematous maculopapular exanthema, predominantly on the trunk and proximal limbs, with rare involvement of face and distal limbs. Less common manifestations include persistent erythematous plaques and pustular lesions. A constant histopathologic finding is the presence of interstitial dermal neutrophils aligned between the collagen bundles. This pattern may provide an easy accessible clue for the definitive diagnosis of AOSD and exclude other diagnosis such as drug eruptions or infectious diseases
A Case of Superficial Granulomatous Pyoderma Mimicking a Basal Cell Carcinoma
Full text linkPyoderma gangrenosum (PG) is a rare neutrophilic dermatosis of unknown etiology with distinct clinical manifestations, frequently associated with systemic diseases. Four clinical and histological variants have been described: ulcerative, pustular, bullous and vegetative. We report a case of Superficial Granulomatous Pyoderma (SGP), a vegetative form of PG, in a 40-year-old woman. Physical examination revealed an erythematous crusted plaque, measuring 2 cm in diameter, located on her left hip, presented 18 months ago. Dermoscopy showed lack of pigment network, large gray-blue ovoid nests, irregular peripheral vessels and ulceration. Laboratory examinations were normal; smears and cultures for bacteria and fungi were negative. Clinical and dermatoscopical presentation suggested diagnosis of a basal cell carcinoma. The lesion had been totally removed: histological examination showed pseudoepitheliomatous hyperplasia with intraepidermal micro-abscesses and prominent dermal inflammatory infiltrate with typical three-layered granulomas consisting of palisading suppurative granulomas surrounded by plasma cell and eosinophils (diffuse neutrophilic infiltration with dermal inflammatory infiltrates consisting of epithelioid histiocytes, lymphocytes and multinucleated giant cells). Based on clinical and histological correlation, SPG was definitively diagnosed
Red eczematous melanoma: a case report with review of the literature
No full textEczematous melanoma is a rare form of amelanotic melanoma appearing clinically as an erythematous macula or plaque, and dermoscopically characterized by the reduction or absence of pigmented network, resulting difficult for an early suspicion and detection. We describe a case of an amelanotic melanoma presented as a reddish, asymptomatic, non-pigmented scaly plaque localized on the left shoulder of a 78-year-old male patient. Histological examination revealed an ulcerated superficial spreading melanoma (Breslow thickness 0.85 mm and Clark level III), associated with epidermal spongiosis and lymphocytic inflammatory infiltrate. A review of the clinical, histological and dermoscopic features of the other 12 published similar cases revealed that eczematous amelanotic superficial spreading melanoma is quite rare, equally distributed in both sexes, more frequent in the elderly, mostly localized at the extremities and usually diagnosed at an advanced stage
Videodermoscopic follow-up: a retrospective clinical study
No full textBackground. Digital monitoring, commonly referred as ‘mole mapping’, provide computer storage of clinical and dermoscopic images of nevi facilitating detailed follow-up. Marking of atypical melanocytic lesions lacking melanoma-specific criteria during baseline visit has been shown helpful for future detection in shape, colour, or surface changes occurring in any lesion, and identification of new lesions’ onset by comparing them to sequential registries.Objective. To evaluate the effective utility of videodermoscopy in the early diagnose of melanoma and in minimizing the number of surgical removals.Materials and methods. A 7-year-retrospective study occurred between 30 November 2007 and 30 April 2014 was performed. Two hundred and eleven patients (124 males, 87 females) were enrolled.All patients were evaluated using the digital dermoscopic photography and were registered in the database for at least a 3-year-follow-up period.The suspected melanocytic nevi were surgically removed, analysed and diagnosed as nevus, dysplastic (mild, moderate, severe) nevus and melanoma.Results. A total of 6493 nevi were marked with the digital follow-up and solely 2.3% of these nevi were excised. The removed lesions resulted to be 42 (28%) dysplastic and only 5 (3%) melanomas.The ratio between total lesions removed and melanomas was =1:30. The dysplastic lesions resulted to be nevi with mild, moderate and severe dysplasia in 50, 31 and 19% of the cases respectively.The majority of the patients were Fitzpatrick’s skin phototype III (64%) but the most frequent diagnosis of dysplastic nevi occurred in patients with phototype IV (33%).Conclusions. Dysplastic nevi and melanomas can be diagnosed at any time during the digital followup period, and not only at the first examination. Videodermoscopy minimizes surgical removals of atypical nevi
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