A new, innovative, and safe treatment in vitiligo: Results of a randomized, double-blinded, parallel-group study.

Vitiligo is a chronic autoimmune disease affecting around 1% of the population worldwide. No existing treatment is giving fully satisfactory results. Further investigations are welcomed for innovative and safe treatments bringing better results. This trial aimed to compare the efficacy and tolerance of various treatment protocols on vitiligo lesions. Four randomized groups of 10 patients with vitiligo covering 8% to 14% of skin surface, except hands and feet were assigned during 8 weeks to (a) UVB microphototherapy 300 to 320 nm (Bioskin-) 1 x week; (b) VITILSI- gel 2 x day; (c) VITILSI- gel 2xday + Bioskin- 1 x week; and (d) placebo 2 x day. Efficacy of the treatment was assessed by planimetry, comparing the photographs of the patients taken at baseline and after 8-week treatment. After completion of the treatment, the increase of the pigment area was 28% in G1 (Bioskin-), 19% in G2 (VITILSI-), 41% in G3 (Bioskin- + VITILSI-) and null in G4. No subject stopped the treatment and no side effect was observed. It was demonstrated that the gel under study was able per se to induce repigmentation in vitiligo lesions and that the results were significantly better when combined with NB-UVB. The protocols used in this trial resulted safe and efficient.

Chemical and mechanical characterization of hyaluronic acid hydrogel cross-linked with polyethylen glycol and its use in dermatology.

Hydrogels based on hyaluronic acid are used to restore volume, hydration, and skin tone, as well as to correct scars, asymmetries or defects of the soft tissue. Hyaluronic acid is often chemically crosslinked with different crosslinking agents in order to improve its mechanical and biological properties. Here we focused on defining the chemical and mechanical characterization of a new hydrogel with specific characteristics: hyaluronic acid polyethylene glycol (PEG)-crosslinked with a high concentration of hyaluronic acid (28 mg/mL), manufactured by MatexLab Spa, via Carlo Urbani 2, ang Via Enrico Fermi, Brindisi, Italy. We made a quantitative and qualitative analysis of the content of sodium hyaluronate in the hydrogel after polymerization and sterilization processes and also evaluated histologically the bio integration of these hydrogels in the cutaneous soft tissues. The results suggest that hyaluronic acid hydrogel PEG-crosslinked have great bio integration, great chemical and mechanical properties, compared with other products available on the market, that are cross-linked with different cross-linking agents. The nontoxicity and nonimmunogenicity of PEG guarantee the lack of allergic and immunological reactions. The PEG-crosslinking technology guarantees a high duration time of the implanted hydrogel because of more resistant physiological degradation.

A new medical imaging technique for diagnosing dermatologic diseases: A clue to treatment choices.

Recently, it has been shown that DNA could emit some waves which carry main information about its evolution. Using this idea, we design a new method to image the behavior of skin cells, especially melanocytes, and diagnose their damage. In this method, we make use of a circuit which is formed from DNAs within the damaged melanocytes, a graphene sheet, DNAs within the healthy cells, and a scope. To amplify exchanged waves between hexagonal and pentagonal manifolds of DNAs, we induce some defects in the graphene sheets and replace some hexagonal molecules by pentagonal ones to build a structure similar to the structure of DNAs. We show that unprotected exposure to UVA and UVB damages the DNA in melanocyte cells, producing genetic defects, or mutations, that can lead to exchanged waves between cells and the emergence of a current in our circuit. By analyzing the evolution of this current, we can estimate the rate of destruction in melanocytes, and predict the emergence of cancer.

5-Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety.

Androgenetic alopecia (AGA) is a multifactorial disease that carries a significant psychological burden with it. Dihydrotestosterone, the main pathogenic androgen in AGA, is produced by conversion of testosterone, which is catalyzed by the 5-alpha reductase (5-AR) isoenzyme family. Finasteride and dutasteride are inhibitors of these enzymes. Finasteride, which is a single receptor 5-alpha reductase inhibitor (5-ARI), acts by blocking dihydrotestosterone (DHT). Dutasteride, a dual receptor DHT blocker, has a higher potency than its predecessor, finasteride. This review corroborates the evidence of superiority of dutasteride over finasteride, and its comparable safety profile concerning fertility, teratogenicity, neurotoxicity, and hepatotoxicity.

Remodeling of collagen constituting interlobular septa of subcutaneous adipose tissue following microwaves application.

In this study, the application of a recently introduced device based on electromagnetic energy transfer by microwaves for fat reduction, permitted to study specifically the modifications of thick fibrous collagen interlobular septa in the subcutaneous adipose tissue, related to the formation of large clusters of adipocytes. The use of Picrosirius red staining associated with circularly polarized microscopy gave evidence of appreciable modifications of the fibrous connective tissue forming septa. Compact fibrotic bundles of collagen I forming interlobular septa appeared reduced or dissolved, in part substituted by the increase of more diffuse and finely reticular collagen III. Remodeling of fibrous collagen, which formed bridles involved in the appearance at the surface of the skin of dimpling/orange peer pattern typical of cellulite, was observed.

Integrative Approach to Psoriasis Vulgaris.

In this article, we present a literature review of the most popular and commonly used therapeutic procedures belonging to complementary and alternative medicine, which is part of the modern concept of integrative medicine, used in the treatment of psoriasis. Psoriasis is a chronic, systemic, inflammatory disease wherein skin changes are the most visible sign. It occurs in approximately 1% to 3% of the world population, and the National Psoriasis Foundation of the United States estimates the number of patients in the whole world at about 125 million. Psoriasis primarily affects the skin, burdening patients with inflamed, pruritic, and sometimes painful lesions covered with whitish scales that last for years. Because of its prevalence in the general population, diversity of the clinical picture (from minimal and localized lesions without subjective symptoms to life-threatening conditions), and disease duration (practically a lifetime), psoriasis is a disease that has become a focus of modern medicine, and therapeutic options for the treatment of psoriasis are currently very numerous and diverse. Conventional treatment of psoriasis is guided by the so-called principle of "steps," where treatment options are applied according to the severity of illness assessed by a physician. Apart from the official therapy for psoriasis, as it is defined and understood in modern developed societies, there exists in parallel a great number of traditional, complementary, and alternative psoriasis treatments, which are based on the beliefs, experiences, and theories inherent to different cultures; in this article, we have analyzed the literature related to some of these procedures.

The effect of age and compression strength on venous leg ulcer healing.

Objectives The aim of the study is to compare proportions of venous leg ulcers healed in patients treated with two different sub-bandage pressure values in relation to age. Methods The study included 102 outpatients with venous leg ulcers, one group with moderate compression pressure of 35-40 mmHg and the second with high pressure >45 mmHg. Each group was divided into two subgroups according to the age (≥65 vs. <65 years). Computerized planimetry was used to measure the size of the ulcers at 6, 12, 18 and 24 weeks. Results Kaplan-Maier analysis showed high pressure leads to higher proportion of healed venous leg ulcers, compared to moderate pressure, in patients aged ≥65 years (57.6% vs. 28%) and in patients <65 years (53.8% vs. 36%) (p < 0.05). Conclusion The study showed that higher compression pressure leads to higher proportions of venous leg ulcers healed, independent of age and could be safely preferred in older patients.