The Importance of Dermoscopy in Early Recognition of Melanoma in Situ.

Early recognition of melanoma in situ (MIS) is an ongoing challenge in dermatology. It rarely arises 'de novo', most frequently resulting due to the transformation of an atypical nevus. The diagnostic criteria for MIS are diverse dermoscopy being the most used and it has a sensitivity of 83% and a specificity of 69% in detecting melanomas. The main objective of our study was to establish the sensitivity and the specificity of each of the 7-point checklist criteria used to differentiate melanocytic nevi from in situ malignant melanoma. The study group included 200 patients, aged over 18 years, with atypical pigmentary nevi after clinical aspects that presented changes in clinical appearance (shape, color, dimensions) during the last 6 months. On each patient we used the 7-point checklist of Argenziano (C1-C7). The study was performed at the Medical Center Dr. Ianosi, in Craiova between January 2016 and September 2018 and it was used Molemax HD computerized dermatoscope. The C1÷C3 criteria are significantly relevant in establishing the diagnosis of MIS in comparison with the diagnosis of nevus, unlike the C4-C7 criterion that is not definitely relevant for confirmation of the MIS diagnosis. There are no enough specific dermoscopic criteria to differentiate MIS from atypical nevus.

Comparative efficacy of oral contraceptive versus local treatment versus intense pulsed light combined with vacuum in endocrine acne in women.

Acne is the most common affection of adolescents, although it can be also found in adult women. Our study was aimed at the comparative assessment of three different therapies over a three-month period, applied to women with moderate comedogenic and papulo-pustular endocrine acne. In the study 116 female patients with endocrine localized face acne were included and divided into three groups: group I with 42 patients was treated with a combination of contraceptive pill + local treatment + pulsed-vacuum light; group II with 38 patients was treated with contraceptives and pulsed-vacuum light and group III with 36 patients was treated only with local treatment. The acne evaluation was made using the Global Acne Grading System (GAGS). Statistical data processing was carried out using the STATA software. For the comedogenic form of acne, the good and very good results were superior in group I vs group II and III (83.33% vs 31.58% vs 5.56%) at the end of the three months of treatment. For the papulo-pustulous form of acne, good and very good results were similar in groups I and II (92.86% vs 73.68%) both after the first month of treatment and at the end of the study, well above the local treatment group (13.99%). Our study highlighted the superiority of laser treatment combined with hormonal treatment, compared to hormonal and local treatment in the comedogenic form of acne, and the superiority of hormonal treatment combined (or not) with laser treatment in the papulo-pustular form compared to local treatment.

Treatment of Lower Limbs Telangiectasias with Nd: Yag Laser-Prospective Study on 446 Patients.

In the last two decades Nd: YAG laser has become a standard of treatment of telangiectasias of the lower limbs in C1EAP stage of chronic venous insufficiency. This paper shows the results of a two years study period of telangiectasias of lower limbs with Nd: YAG laser conducted in a specialised centre in this type of procedures. The study group consisted of 446 patients (21 males and 425 females) with telangiectasias (C1EAP) on the lower limbs between January 2016-December 2017. The patients had to complete a form in which they noted the initial state on a scale from 1 to 10 but also the result of the treatment and the intensity of the pain during the laser treatment. Moreover, the doctor also evaluated the results of the treatment for each and every patient taking also into account the initial phase of the disease. We observed a significant improvement of the clinical appearance (the reduction of telangiectasias) almost in the entire study group, regardless of the gender and the age, but the intensity of the pain was higher in men and in persons under the age of 30. Based on these data we can conclude that Nd: YAG laser represents a minimally invasive therapeutic option with minor side effects and major aesthetic results and furthermore it can be combined with several other methods (microsclerotherapy, radiofrequency, complex surgery) in order to improve peripheral chronic venous insufficiency.

Rupatadine in the treatment of chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled multicentre study.

BACKGROUND: Chronic urticaria is one of the most common and disturbing cutaneous condition. The treatment of chronic idiopathic urticaria (CIU) is still a challenge. Antihistamines are recommended as first-line treatment. Rupatadine is a new potent nonsedative anti-H1. OBJECTIVE: To study rupatadine efficacy and safety for moderate to severe CIU treatment. METHODS: This randomized, double-blind, placebo-controlled, parallel-group, multicentre, study was designed to assess primarily mean pruritus score (MPS) reduction with rupatadine, 10 and 20 mg, administered once daily for 4 weeks. Three hundred and thirty-three patients with active episodes of moderate-to-severe CIU were included. RESULTS: A 57.5% (P < 0.005) and 63.3% (P = 0.0001) significative MPS reduction from baseline, was observed at week 4 with 10 and 20 mg rupatadine, respectively, compared with placebo (44.9%). Both doses of rupatadine were not significantly different at any time point, with respect to their effects on pruritus severity, number of wheals and total symptoms scores. Rupatadine 10 mg had an overall better adverse event profile. CONCLUSION: Rupatadine 10 mg is a fast, long-acting, efficacious and safe treatment option for the management of patients with moderate-to-severe CIU.