Psoriasis dermatitis: a new entity or a different phenotypic expression of psoriasis and atopic dermatitis?

BACKGROUND: Psoriasis (P) and atopic dermatitis (AD) share some common characteristics. The resulting clinical picture with shared manifestations is a new entity called psoriasis dermatitis (PD), atopic psoriasis or psorema. The purpose of this study was to identify the clinical manifestations of this new dermatological condition, focusing on the adult population. METHODS: We recruited adult patients from two outpatient clinics, the "severe psoriasis" and the "adult atopic dermatitis," between January 1st, 2021, and December 31st, 2021. The 26 patients meeting the inclusion criteria were followed for 12 months, and two control groups of patients were enrolled in the same period. RESULTS: The frequencies of the variables examined within the patients affected by PD were compared with those of P or AD group. The age at disease onset was significantly higher in PD patients and the duration of symptoms was also significantly lower in PD patients, compared to both P and AD groups. Affected areas were similar between PD and P, instead the scalp, feet and genitals were more frequently involved in the PD group than in the AD group. CONCLUSIONS: P and AD seem part of a spectrum rather than a dichotomy, where PD is an entity in the middle of this spectrum.

Branching Dilated Vessels: A Possible Trichoscopic Clue for Diagnosis of Erosive Pustular Dermatosis of the Scalp in Children.

Introduction: Erosive pustular dermatosis of the scalp (EPDS) is an inflammatory scalp condition that usually affects the elderly, while only few cases have been reported in childhood. In children, it may mimic fungal or bacterial infections, especially kerion. Case Presentation: We describe the usefulness of trichoscopy as a supportive diagnostic tool in 2 cases of pediatric EPDS. Discussion: Clinical distinction between EPDS and different types of alopecia in children is difficult, with a significant likelihood of diagnostic errors and delay in therapy. Trichoscopy may provide a noninvasive option that can help avoid invasive diagnostic procedures in children.

Hypericum and neem oil for dehisced post-surgical wounds: a randomised, controlled, single-blinded phase III study.

OBJECTIVE: To evaluate the clinical efficacy of a hypericum and neem oil dressing, Primary Wound Dressing [ONE] (1PWD) (Kerecis AG, Switzerland), in a patient population with dehiscence of surgical wounds with critical colonisation/infection. Efficacy was defined as resolution of inflammatory/infective symptoms. METHOD: A randomised, controlled, single-blinded, parallel-arms phase III study was conducted comparing the experimental medication to silver-based dressings. All patients were evaluated at enrolment, on days 7, 14, 21 and 28. Improvement of inflammatory/infective symptoms was measured by detecting seven items of the Bates-Jensen Wound Assessment Tool (BWAT). Pain was assessed using the Numeric Rating Scale (NRS). RESULTS: The study enrolled 99 patients. Follow-up was completed in 49 patients in the experimental group and 48 patients in the control group. Overall BWAT evaluation demonstrated similar outcomes between the groups: t=0.23, p-value=0.81, 95% confidence interval (CI): -13.3-10.8. Furthermore, when evaluating the seven items of the BWAT relating to inflammatory signs, there was not a significant difference between the groups: t=0.38, p=0.35, 95% CI: -2.8-2.7. However, when an analysis using the NRS pain scale was performed, a statistically significant pain reduction was demonstrated in favour of the experimental group: t=7.8, p<0.0001, 95% CI: 2.918-4.8819. CONCLUSION: This randomised controlled trial confirmed the efficacy of 1PWD, an investigational product, in the management of surgical dehiscence with critical colonisation or infection, with the added benefit of significant pain reduction when compared with a silver-based dressing.

Fractional CO2 laser therapy of lichen sclerosus in males: a new therapeutic opportunity?

INTRODUCTION: Lichen sclerosus (LS) is a chronic relapsing disease with a predilection for the anogenital areas of patients of both sexes and at all ages. In males, LS is usually a late diagnosis, increasing the odds for serious complications up to the worse clinical scenario. LS is known to affect the quality of patients' social and interpersonal life. Here, we designed a study to monitor the possible beneficial effects of fractional photo-thermolysis with CO2 laser for treating penile LS during a non-active phase of the disease. METHODS: Ten patients were enrolled in this study. They all underwent three ablation laser sessions, followed by a follow-up visit 6 months after the last treatment. In four out of five visits conducted, questionnaires were filled in by both clinician and patients to evaluate outcomes on quality of life (DLQI test), symptoms of LS (MenLas Observer Scale and MenLas Patient Scale), and sexual function (MSHQ questionnaire). RESULTS: Our study shows that treatment with fractioned laser CO2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life. CONCLUSIONS: Our study shows that treatment with fractioned laser CO2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life.

A peristomal plaque of sudden occurrence.

Koebner phenomenon regards the formation of a psoriatic lesion after a trauma, including tattoo, insect bite or other injuries. Although this manifestation is not specific for psoriasis, physicians should be aware because early recognition may be helpful in making the diagnosis when present.

Photodynamic therapy following fractional CO2 laser for treatment of primary vulvar Paget's disease: does it really work?

INTRODUCTION: Extra-mammary Paget's disease is a rare form of intraepithelial adenocarcinoma with a variable pattern of invasion. Vulvar Paget's disease represents 1% of all vulvar cancers. Standard treatment is surgical excision, however, the recurrence rate is high and surgery leads to anatomical, functional and sexual morbidity. Some studies suggest the efficacy of photodynamic therapy following CO2 Laser irradiation as treatment for this disease. METHODS: In the present study, ten patients with vulvar Paget's disease underwent fractional carbon dioxide (CO2) laser abrasion, followed by 3 h of occlusive application of aminolaevulinic acid (ALA) and then 100 J/cm2 irradiation with a 630-nm lamp. This combination treatment regime was repeated every 2 weeks for a total of 5 times. RESULTS: At the end of the 12-month follow-up period, only two patients maintained a complete remission of the disease and recurrence was observed in all patients who had originally shown a partial remission. CONCLUSIONS: According to our experience, Photodynamic Therapy-ALA following fractional CO2 Laser does not seem to be an effective treatment for vulvar EMPD in the long term.