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3.
Dermatology ; 239(3): 454-461, 2023.
Article in English | MEDLINE | ID: mdl-36716709

ABSTRACT

BACKGROUND: Folliculitis decalvans (FD) is a rare primary neutrophilic scarring alopecia whose etiology has not been completely elucidated yet. OBJECTIVE: The aim of the study was to determine if the follicular microbiota residing in FD-affected hair follicles had a distinct microbiological signature and if an aberrant immune response was present in the pathogenesis of FD. METHODS: We conducted a cross-sectional study of 10 patients affected by FD. Trichoscopy-guided follicular biopsies were taken from affected and healthy scalp to identify the follicular microbiome using next-generation sequencing. We searched for microbiological biomarkers of FD-affected follicles using the linear discriminant analysis (LDA) effect size (LEfSe) tool. Additionally, peripheral blood mononuclear cells were obtained, and their cytokine production was quantified after incubation with pathogen-associated molecular patterns isolated from patients' biopsies and compared with healthy controls. RESULTS: ß-diversity analysis showed statistically significant differences regarding bacteria comparing follicular microbiota of healthy and FD-affected hairs. Ruminococcaceae, Agathobacter sp., Tyzzerella sp., and Bacteriodales vadin HA21 family were good predictors of disease status. IL-10, TNF-α, and IL-6 levels were significantly decreased in patients after incubation with various strains of bacteria compared with controls. CONCLUSION: FD hair follicles have a specific heterogenous follicular bacterial microbiota signature. Additionally, these patients seem to have an impaired immunological response.


Subject(s)
Alopecia , Folliculitis , Hair Follicle , Folliculitis/microbiology , Folliculitis/pathology , Alopecia/etiology , Humans , Hair Follicle/pathology , Leukocytes, Mononuclear , Case-Control Studies , Cytokines , Microbiota , Biopsy , Cross-Sectional Studies , Male , Female , Adult , Middle Aged
10.
J Cosmet Dermatol ; 21(7): 2939-2944, 2022 Jul.
Article in English | MEDLINE | ID: mdl-34766699

ABSTRACT

BACKGROUND: Pliaglis® is a self-occluding topical anesthetic containing a eutectic mixture of 7% lidocaine and 7% tetracaine, with proven efficacy and safety in several trials. AIMS: To evaluate the effectiveness and safety of Pliaglis® for different dermatological procedures in real-life clinical practice. METHODS: This retrospective, multicenter study included 35 patients treated with Pliaglis® prior to five dermatological procedures (pulsed dyed laser, picosecond laser, non-ablative fractional laser, radiofrequency microneedling, and photodynamic therapy). The primary endpoint was to assess the pain during the procedure with a visual analogue score (VAS) from 0 (no pain) to 10 (most severe pain). Secondary endpoints were the global effectiveness and tolerability (from 0 = very low to 10 = excellent), and the adverse events (AEs) after Pliaglis® removal, classified according to intensity (1-3). RESULTS: The median and mean pain VAS reported by patients was 2 (range 0-9) and 2.9 (±2.3), respectively. More than 65% of the patients had a VAS score ≤3. The effectiveness reported by investigators was "very good" (median 8 [range 2-10], mean 7.5 [±1.9]), which was strongly correlated with the pain VAS reported by patients (Spearman coefficient = - 0.9; p < 0.001). Forty-five percent of patients reported AEs and they were transient and mostly mild, with a mean intensity score of 1.5 (range 1-3). Tolerability of Pliaglis® was reported by investigators as "excellent" (median 10 [range 1-10], mean 9 [±1.8]). CONCLUSIONS: Pliaglis® is an effective topical anesthetic for several dermatological procedures, with an excellent safety and tolerability profile.


Subject(s)
Anesthetics, Local , Tetracaine , Administration, Topical , Anesthetics, Local/adverse effects , Double-Blind Method , Humans , Lidocaine/adverse effects , Pain/chemically induced , Pain Measurement , Retrospective Studies , Tetracaine/adverse effects
13.
Aust J Gen Pract ; 502021 05 03.
Article in English | MEDLINE | ID: mdl-33987629

ABSTRACT

A woman presented to the emergency department during the COVID-19 pandemic, reporting a slightly pruritic rash that had developed five days after the onset of fever, cough and malaise.


Subject(s)
COVID-19 , Exanthema , Exanthema/etiology , Female , Fever/etiology , Humans , Pandemics , SARS-CoV-2
16.
J Am Acad Dermatol ; 84(6): 1644-1651, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33639244

ABSTRACT

BACKGROUND: The major concern regarding the use of low-dose oral minoxidil (LDOM) for the treatment of hair loss is the potential risk of systemic adverse effects. OBJECTIVE: To describe the safety of LDOM for the treatment of hair loss in a large cohort of patients. METHODS: Retrospective multicenter study of patients treated with LDOM for at least 3 months for any type of alopecia. RESULTS: A total of 1404 patients (943 women [67.2%] and 461 men [32.8%]) with a mean age of 43 years (range 8-86) were included. The dose of LDOM was titrated in 1065 patients, allowing the analysis of 2469 different cases. The most frequent adverse effect was hypertrichosis (15.1%), which led to treatment withdrawal in 14 patients (0.5%). Systemic adverse effects included lightheadedness (1.7%), fluid retention (1.3%), tachycardia (0.9%), headache (0.4%), periorbital edema (0.3%), and insomnia (0.2%), leading to drug discontinuation in 29 patients (1.2%). No life-threatening adverse effects were observed. LIMITATIONS: Retrospective design and lack of a control group. CONCLUSION: LDOM has a good safety profile as a treatment for hair loss. Systemic adverse effects were infrequent and only 1.7% of patients discontinued treatment owing to adverse effects.


Subject(s)
Alopecia/drug therapy , Minoxidil/adverse effects , Administration, Oral , Adolescent , Adult , Aged , Aged, 80 and over , Child , Dizziness/chemically induced , Dizziness/epidemiology , Edema/chemically induced , Edema/epidemiology , Female , Headache/chemically induced , Headache/epidemiology , Humans , Hypertrichosis/chemically induced , Hypertrichosis/epidemiology , Male , Middle Aged , Minoxidil/administration & dosage , Retrospective Studies , Sleep Initiation and Maintenance Disorders/chemically induced , Sleep Initiation and Maintenance Disorders/epidemiology , Tachycardia/chemically induced , Tachycardia/epidemiology , Young Adult
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